Senior Advisor, Payment Operations

Centers for Medicare & Medicaid Services • Rockville, MD

12d

About The Position

This position is in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid Innovation (CMMI), Seamless Care Model Group (SCMG). The Senior Advisor, Payment Operations (GS-0301-14) leads Medicare payment operations, guides Fee-For-Service (FFS) system changes, and coordinates care delivery model implementation across CMMI's SCMG.

The role directs programming and policy changes for Medicare payment systems to ensure new care models are implemented accurately and efficiently. It continuously tracks payment processes to identify and resolve problems before they affect model operations or participants. The Senior Advisor serves as the primary contact among CMS groups, contractors, and Medicare Administrative Contractors for technical payment changes; advises program directors on policy changes, new initiatives, and operational improvements; and guides junior team members while reviewing their work for quality and consistency.

Applicants must be U.S. citizens or nationals and are subject to a background and suitability investigation. A one-year probationary period may be required. The role has a regular and recurring reporting requirement to a CMS office listed in the announcement. CMS offers flexible working arrangements and alternative work schedules at the manager's discretion.

Requirements

• At least one year (52 weeks) of specialized experience equivalent to the GS-13 grade level in the Federal government, gained in the public or private sector.
• Experience analyzing Medicare fee-for-service payment systems to identify technical requirements for implementing alternative payment or care delivery models.
• Experience advising agency leadership and internal stakeholders on Medicare payment policy to support the design, testing, or evaluation of value-based care models.
• Experience coordinating with Medicare contractors or CMS business components to implement payment system changes supporting new or existing care delivery initiatives.
• Experience preparing technical reports and briefings on Medicare payment operations to communicate findings and recommendations to agency officials or leadership.
• U.S. citizenship or nationality.
• Resume of no more than two pages, with detailed information demonstrating relevant responsibilities and specialized experience.
• Meet all qualification requirements by the announcement closing date.

Responsibilities

• Direct programming and policy changes for Medicare payment systems to ensure new care models are implemented accurately and efficiently.
• Continuously track payment processes and identify and resolve problems before they affect model operations or participants.
• Serve as the main point of contact among CMS groups, contractors, and Medicare Administrative Contractors to carry out technical payment changes.
• Provide expert recommendations to program directors on policy changes, new initiatives, and ways to improve model operations.
• Guide junior team members on payment processes and review their work for quality and consistency.

Benefits

• Federal employees and their families have access to a comprehensive benefits package.
• Flexible working arrangements and alternative work schedules may be available at the manager's discretion.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed