Lead Auditor

Centers for Medicare & Medicaid Services•Woodlawn, MD

About The Position

The Lead Auditor serves in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Office of Financial Management, Payment Accuracy & Reporting Group (PARG), Division of Exchange Error Rate Measurement (DEERM). The position provides permanent, recurring, and officially assigned team leadership to the DEERM audit team for the Exchange Improper Payment Measurement (EIPM) program. The Lead Auditor leads SEIPM and FEIPM teams by translating CMS priorities into assignments, balancing workloads, coaching staff, tracking milestones, and ensuring timely and accurate audit deliverables that comply with PIIA and applicable standards. The role provides technical guidance on audit methods, sampling, measurement protocols, GAS and GAAP, and PIIA; reviews work for accuracy and defensibility; resolves issues; and maintains program guidance and records. The position oversees analyses and audits of Federally Facilitated and State-Based Exchange improper payment measurement, refines audit protocols, assesses payment vulnerabilities, and recommends improvements. It analyzes proposed legislation, regulations, policies, and procedures for their effects on Exchange improper payment programs; advises officials on audit and compliance implications; and recommends updates. The Lead Auditor coordinates audit communications with CMS leadership, Federal and State agencies, OMB, GAO, OIG, contractors, and stakeholders; prepares reports and responses; and presents findings and recommendations.

Requirements

At least one year (52 weeks) of qualifying specialized experience equivalent to the GS-13 grade level in the Federal government, obtained in either the private or public sector.
Experience analyzing policy issues on improper payment measurement programs.
Experience conducting special studies on improper payment measurement programs.
Experience advising on audit methods and problem-solving approaches for improper payment measurement issues.
Experience auditing completed work for accuracy, defensibility, and compliance.
U.S. Citizen or National.
Meet applicable time-in-grade restrictions; current Federal employees must have served at least 52 weeks at the next lower grade level.
Subject to a background and suitability investigation.
Males born after December 31, 1959, must be registered or exempt from Selective Service.
A one-year probationary period may be required.
If selected, employment eligibility documentation presented for DHS Form I-9 will be verified through E-Verify.
Federal employees are required to receive Federal salary payments by direct deposit.
Resume limited to no more than two pages and must detail experience relevant to the responsibilities and specialized experience.

Responsibilities

Lead SEIPM and FEIPM teams by translating CMS priorities into assignments, balancing workloads, coaching staff, tracking milestones, and ensuring timely, accurate audit deliverables.
Provide technical guidance on audit methods, sampling, measurement protocols, GAS and GAAP, and PIIA.
Review audit work for accuracy, defensibility, and compliance; resolve issues; and maintain program guidance and records.
Oversee analyses and audits of Federally Facilitated and State-Based Exchange improper payment measurement.
Refine audit protocols, assess payment vulnerabilities, and recommend improvements.
Analyze proposed legislation, regulations, policies, and procedures for their effects on Exchange improper payment programs.
Advise officials on audit and compliance implications and recommend updates.
Coordinate audit communications with CMS leadership, Federal and State agencies, OMB, GAO, OIG, contractors, and stakeholders.
Prepare reports and responses and present findings and recommendations.