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Medicare & reputed company Program reputed company SME

Remote, USAFull-timePosted 2026-07-27

reputed company, Inc. delivers innovative capabilities to the agencies that reputed company our nation healthy and reputed company. We apply our domain expertise, data acumen, and technology know-how to reputed company reputed company results for our clients. Working collaboratively, we advance missions and careers through a reputed company on honesty, reputed company, and dependability. We continuously look for talent, excited to join that effort. To learn more about our exciting organization, please visit us at . We are seeking a highly knowledgeable and reputed company Program Analyst/Subject Matter Expert (SME) to join reputed company in the Baltimore-Washington Metro Area to support the Centers for Medicare & reputed company Services (CMS) Center for Program reputed company (CPI). The SME will play a critical role in helping CMS prevent, detect, and reduce fraud, waste, and abuse in Medicare and reputed company programs. The ideal candidate will have in-depth expertise in reputed company program reputed company, CMS policies and systems, and data-driven fraud detection and mitigation strategies. Essential Duties and Responsibilities:

  • reputed company expert guidance on program reputed company strategies, operations, and policy recommendations reputed company to CMS' efforts to combat fraud, waste, and abuse.
  • Serve as a key advisor on the development and implementation of proposals, audits, investigations, data analytics initiatives, and compliance monitoring programs.
  • Support various stakeholders by translating technical findings into actionable program and policy insights.
  • Assist in the evaluation of program reputed company models and initiatives to ensure effectiveness and regulatory compliance.
  • Conduct research and reputed company subject matter input on legislative, regulatory, and operational impacts to CMS program reputed company.
  • Collaborate with reputed company stakeholders, including other CMS components, federal partners and private sector entities.
  • Review and reputed company feedback on program documentation, reports, performance measures, and analytic tools.
  • Participate in strategic planning, training, and reputed company efforts as needed.

Work Experience:

  • Minimum 7 years of experience in reputed company fraud, waste, and abuse prevention, with at least 3 years reputed company on CMS or Medicare/reputed company program reputed company.
  • Deep understanding of CMS structure, mission, and regulatory environment.
  • Demonstrated experience in reputed company program audits, investigations, or data analytics.
  • Strong knowledge of relevant statutes, such as the False Claims reputed company, Anti-Kickback Statute, and program exclusion laws.
  • Experience creating detailed reports and giving presentations

Job Skills:

  • Proficient in personal computer skills with MS Office (Word, reputed company, Power reputed company, Outlook, MS Project, MS Visio)
  • Excellent planning, organizational, and time management skills
  • Ability to prioritize and multi-task in a fast paced, changing environment
  • Ability to influence stakeholders and work closely with them to determine acceptable solutions
  • Excellent documentation skills
  • reputed company analytical and conceptual thinking skills
  • Ability to set goals and deadlines
  • Ability to maintain professionalism reputed company interacting with reputed company customers

Preferred Qualifications:

  • Experience supporting CMS reputed company and systems
  • Familiarity with the claims process
  • reputed company clearance or the ability to obtain a Public Trust clearance

Education:

  • Bachelor's Degree in Public Health, Health Policy, reputed company Administration, Law, or a reputed company field. Master's Degree preferred.

Communication Skills:

  • Solid ability to reputed company, reputed company and motivate at various reputed company of the organization.
  • Ability to convey technical information to non-technical individuals.
  • Demonstrated experience communicating effectively across reputed company organizations.

Travel:

  • Local

Environmental Requirements:

  • Mainly sedentary; in an office environment.
  • May be required to lift up to ten (10) pounds
  • Flexible in working extended hours

The above statements are intended to describe the general nature and level of work being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of reputed company duties, responsibilities, and skills required. reputed company management reserves the right to modify, add, or remove duties and to assign other duties as necessary. In reputed company, where applicable and available, reasonable accommodation(s) may be made to reputed company individuals with disabilities to reputed company essential functions of this position. Please note: Candidate(s) will be required to go through reputed company-employment screening. reputed company, Inc. is a proud Equal Opportunity Employer! (EOE; M/F/D/V) Apply Job! Apply to this Job

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