“As the Director, Investigations and Audits Group (IAG), CPI, you will provide leadership and executive direction for CMS’ comprehensive Program Integrity (PI) audits strategy, including providing technical guidance on all Medicare and Medicaid program integrity enforcement activities in relation to fraud, waste and abuse.”
“Responsibilities:
- Leads the development of an integrated and coordinated national framework for PI audit policy and procedures across the Medicare and Medicaid programs and capitalize on economies of scale whenever possible and feasible.
- Serves as the CMS primary point of contact and a conceptual expert for high priority and comprehensive audits strategy for the nationwide detection and prevention of fraud, waste, and abuse in the Medicare and Medicaid programs.
- Oversees and coordinates the operations of the CPI Medicare and Medicaid field offices. Oversees the daily activities of the Unified Program Integrity Contractors.
- Collaborates with other CMS components by reviewing State corrective action plans from a Medicaid program integrity perspective.
- Collaborates with other CMS components to establish a PI focus on managed care in both Medicaid and Medicare programs.
- Directs and assures that enforcement procedures related to C MPs and violations of Anti-Kickback Statutes, are carried out.
- Serves as the primary focal point for collaboration with the Department, the Office of Inspector General, the Department of Justice, and the States on the Secretary’s, and U.S. Attorney General’s HEAT initiative.
- Participates in the processing and tracking of undercover law enforcement operations.
- Works with Centers and Offices across CMS to identify and monitor program vulnerabilities and promotes changes in policy as necessary…”
Read the full job description here.
G2X TAKE: Those who support the Centers for Medicare and Medicaid Services may want to influence who applies for this SES role that will provide leadership and executive direction for CMS’ comprehensive Program Integrity (PI) audits strategy, including providing technical guidance on all Medicare and Medicaid program integrity enforcement activities in relation to fraud, waste and abuse.
