Health Data Lead, Senior Manager

Key Role:

Lead and grow an analytics team with responsibility to perform advanced analyses and studies of Centers for Medicare and Medicaid Services (CMS) claims and administrative data to assist CMS with health care and payment policy rulemaking activities; monitor and assess the impact of policy and payment changes on access to care, beneficiary health outcomes, and Medicare payments; and conduct active surveillance of notable trends in Medicare payment systems. Assist CMS in its efforts to identify and assess exposure to fraud, waste, and abuse in the Medicare program; evaluate the impact of initiatives aimed at preventing or recovering improper payments; and conduct numerous and varied ad hoc data analyses. Leverage client specific knowledge and network to lead, plan, and manage progressively larger and more complex programs in the CMS health sub-account. This position is open to remote delivery anywhere within the U.S., to include the District of Columbia.

Basic Qualifications:

-15+ years of experience in a managerial role overseeing large projects, budgets, and numerous staff

-Experience in working with Centers for Medicare and Medicaid Services (CMS) and Government Payer programs

-Experience with building a payer analytic team and building analytic solutions and products

-Knowledge of CMS claims data including Medicare/Medicaid, in either the IDR or CCW environment with Fee-for-Service (FFS), Medicare Advantage encounter data, or Prescription Drug Event (PDE) data

-Knowledge of analytic scripting, programming languages and packages including SAS Viya, R, Python, Tableau, QuickSight, Qlik

-Knowledge of fraud, waste, and abuse and program integrity programs

-Knowledge of both federal and state payer data, including encounter data, fraud, and program integrity tactics

-Ability to apply Artificial Intelligence (AI) and Machine Learning (ML) and automation techniques to drive insights and efficiency

-Ability to obtain a security clearance

-BA or BS degree

Additional Qualifications:

-Experience with delivering technical assistance to a wide range of stakeholders and using a variety of delivery techniques

-Experience in facilitating large meetings with both internal and external audiences

-Experience with the federal procurement and proposal process

-Possession of excellent relationships in the CMS agency

Clearance:

Applicants selected will be subject to a security investigation and may need to meet eligibility requirements for access to classified information.

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