Deputy Center Director (Medicaid Program Integrity) US Centers for Medicare & Medicaid Services

• 4.0 Woodlawn, MD Job Details Full-time $151,661
• $228,000 a year 21 hours ago Qualifications Quality control corrective actions Healthcare financial misconduct investigations Strategic goal setting Program management Public policy development Budget control Managed care organization experience Regulatory compliance Improving operational efficiency Change management Policy & process development Health insurance knowledge Collaborating with law enforcement agencies Healthcare regulatory compliance policy development Medicaid Healthcare policy development Government healthcare agency experience Team motivation (leadership skill) Risk management leadership (healthcare) Policy Development Senior leadership Full Job Description Summary This position is located in the Center for Program Integrity (CPI) at the Centers for Medicare & Medicaid Services (CMS).

As the Deputy Center Director (Medicaid Program Integrity), you will provide executive leadership, direction and coordination for the management of a cohesive, agency-wide approach to ensuring program integrity across the Medicaid and Children's Health Insurance Program (CHIP). Learn more about this agency This job is open to The public U.S. Citizens, Nationals or those who owe allegiance to the U.S. Senior executives Individuals looking for an executive-level job and who meet the five Executive Core Qualifications (ECQs). Clarification from the agency Open to all groups of qualified individuals from the public, including current employees within the Federal Excepted Service, current employees within the Federal Competitive Service, and current career SES and SES reinstatement eligibles. SESCDP graduates may also apply for noncompetitive consideration. Duties Provides executive leadership and expert knowledge for the agency as it relates to Medicaid program integrity (PI) activities. Directs the identification of program vulnerabilities and actions taken to formulate and implement methodologies to strengthen program integrity efforts emerging with fraud, waste, and abuse in the Medicaid and CHIP programs. Provides strategic direction and oversight for CPI's engagement with State Medicaid agencies on program integrity activities, including the review and approval of State program integrity plans and corrective action plans. Directs CPI's oversight of program integrity activities within Medicaid Managed Care Organizations (MCOs), including the review of encounter data, claims data, and managed care contract compliance. Oversees CPI strategic planning, as well as the establishment of performance goals and measures for CPI and its staff. Provides guidance to ensure appropriate liaison and coordination with the Department, other HHS Operating Divisions, other Federal agencies and other non-Federal organizations necessary to CPI's program integrity operations. Requirements Conditions of employment Must be a U.S. Citizen or National. Subject to a 1-year supervisory probationary period (unless already completed). Complete a Declaration for Federal Employment to determine your suitability for Federal employment, at the time requested by the agency. If you are a male applicant born after December 31, 1959, certify that you have registered with the Selective Service System or are exempt from having to do so. May be subject to pre-employment and random drug tests. You may be required to obtain and maintain an interim and/or final security clearance prior to entrance on duty. Failure to obtain and maintain the required level of clearance may result in the withdrawal of a job offer or removal. The Ethics in Government Act, PL 95-521 requires the applicant selected for this position to submit a financial disclosure statement, OGE-278e, prior to assuming the SES position, annually, and upon termination of employment. Status applicants must submit a copy of their most recent SF-50, Notification of Personnel Action, which verifies status. All initial appointments to an SES position are contingent on approval from OPM's Qualifications Review Board unless the selectee has successfully participated in an OPM approved SES Candidate Development Program. Only experience obtained by the closing date of this announcement will be considered. Qualifications Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution. Candidates will not be hired based on their race, sex, color, religion, or national origin. To meet the minimum qualification requirements for this position, you must show that you possess the Executive Core Qualifications (ECQ) and Technical Qualifications (TQ) related to this position within your resume•

NOT TO EXCEED 2 PAGES.

Resumes over the 2-page limit, will not be reviewed beyond page 2 or may be disqualified. Your resume should include examples of experience, education, and accomplishments applicable to the qualification(s). If your resume does not reflect demonstrated evidence of these qualifications, you may not receive consideration for the position. There is NO requirement to prepare a narrative statement specifically addressing the Executive Core Qualifications (ECQs) or the Technical Qualifications (TQs).

TECHNICAL QUALIFICATIONS

(TQs): Your resume should demonstrate accomplishments that would satisfy the technical qualifications. TQ 1: Demonstrated executive-level experience leading national program integrity efforts for Medicaid, the Children's Health Insurance Program (CHIP), or similar Federal health care programs. This includes developing and leading strategies to prevent, detect, and address fraud, waste, abuse, and improper payments; overseeing nationwide provider oversight and enforcement activities; coordinating audits, investigations, and corrective actions with Federal and State agencies, State Medicaid Fraud Control Units (MFCUs), and law enforcement partners; and achieving measurable results that improved program integrity, strengthened accountability, or reduced improper payments across the country. TQ 2: Demonstrated executive-level experience integrating program integrity into enterprise strategy, policy development, and national operational frameworks for Medicaid, the Children's Health Insurance Program (CHIP), or comparable Federal health care programs. This includes identifying gaps in statutory, regulatory, or policy frameworks; developing and implementing policy, regulatory, or operational solutions to address emerging risks and program vulnerabilities; aligning program integrity initiatives with agency-wide strategic planning, budget priorities, and legislative proposals; and advising senior leadership on program integrity strategy, risk management, and national policy direction.

EXECUTIVE CORE QUALIFICATIONS

(ECQs): In addition to the Technical Qualification Requirements listed above, all new entrants into the Senior Executive Service (SES) under a career appointment will be assessed for executive competency against the following five mandatory ECQs. If your 2-page resume does not reflect demonstrated evidence of the ECQs and TQs, you may not receive further consideration for the position. There are five

ECQs:

ECQ 1: Commitment to the Rule of Law and the Principles of the American Founding

• This core qualification requires a demonstrated knowledge of the American system of government, commitment to uphold the Constitution and the rule of law, and commitment to serve the American people. ECQ 2: Driving Efficiency
• This core qualification involves the demonstrated ability to strategically and efficiently manage resources, budget effectively, cut wasteful spending, and pursue efficiency through process and technological upgrades. ECQ 3: Merit and Competence
• This core qualification involves the demonstrated knowledge, ability and technical competence to effectively and reliably produce work that is of exceptional quality. ECQ 4: Leading People
• This core qualification involves the demonstrated ability to lead and inspire a group toward meeting the organization's vision, mission, and goals, and to drive a high-performance, high-accountability culture. This includes, when necessary, the ability to lead people through change and to hold individuals accountable. ECQ 5: Achieving Results
• This core qualification involves the demonstrated ability to achieve both individual and organizational results, and to align results to stated goals from superiors.

Note:

If you are a member of the SES or have been certified through successful participation in an OPM-approved SES Candidate Development Program (SESCDP) or have SES reinstatement eligibility, you do not need to respond to the ECQs. Instead, you should attach proof (e.g., SF-50, Certification by OPM's SES Qualifications Review Board (QRB)) of your eligibility for noncompetitive appointment to the SES. Education This job does not have an education qualification requirement. Additional information

Veterans' Preference:

Veterans' preference is not applicable to the SES.

Mobility:

Organizational and geographical mobility is essential in developing and managing SES leaders. Individuals selected for SES positions may be subject to reassignment across geographical, organizational, and functional lines, and may be required to sign a Reassignment Rights and Obligation Agreement. Equal Employment Opportunity (EEO)

Policy Statement:

http://www.eeoc.gov/federal/index.cfm Employment Information Resources•

Resource Center:

https://help.usajobs.gov/how-to Males born after 12-31-1959 must be registered or exempt from Selective Service (see https://www.sss.gov/RegVer/wfRegistration.aspx) OPM must authorize any employment offers made to current or former (within the last 5 years) political Schedule A, Schedule C, or Non-career SES employees in the executive branch. If you are currently, or have been within the last 5 years, a political Schedule A, Schedule C, or Noncareer SES employee in the executive branch, you must disclose that to the Human Resources Office. Salary for SES positions varies depending on qualifications. The annual salary range is found at the top of this announcement. The selectee for this position may be eligible for annual performance bonuses and performance-based pay adjustments. This position is designated as a Testing Designated Position (TDP) . You must successfully complete a pre-employment urinalysis drug screening. You will be subject to unannounced random drug testing for the duration of service in this position. Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution. Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution. Benefits A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits. Review our benefits Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered. How you will be evaluated You will be evaluated for this job based on how well you meet the qualifications above. You will be evaluated on the quality and extent of your total accomplishments, experience, and education (if applicable). Your application will be rated and ranked by a Senior Executive Service (SES) Panel, comprised of at least three SES members, using only the information required within the application package. Applicants who do not demonstrate in their application sufficient possession of the ECQs and TQs will be determined ineligible for further consideration. Once the application process is complete, your resume and supporting documentation will be reviewed. If you meet minimum qualifications, your Application Package will be further reviewed to determine if you possess the Executive Core Qualifications (ECQ) and Technical Qualifications (TQ) listed above. ECQs and TQs must be thoroughly addressed within your two (2) page resume. Separate narratives will not be accepted or reviewed. Highly Qualified applicants may undergo one or more interviews and may be referred to the selecting official for further consideration. Upon selection, if not already a member of the SES serving under a career appointment, the individual selected must have his/her executive qualifications certified by the U.S. Office of Personnel Management's SES Qualifications Review Board (QRB) before appointment to this position. The selected individual's application will be forwarded to the OPM for review and certification by the QRB, unless the selectee provides evidence of their noncompetitive status (e.g., a current SES, an OPM QRB-certified SESCDP graduate, or SES reinstatement eligibility). Upon QRB certification, the selected individual will be required to serve a one-year probationary period. For more information regarding the SES, go to https://www.opm.gov/policy-data-oversight/senior-executive-service/. Required Documents A complete application includes items described below. Please note that if you do not provide all required information, as specified in this announcement, you may not be considered for this position (or may not receive the special consideration for which you may be eligible). Please carefully review the following list to determine what documentation you need to submit. Some documents may not apply to all applicants. 1.

RESUME:

All applicants are required to submit a resume limited to two (2) pages (i.e., 1 page that is double-sided or 2 pages that are one-sided each) showing all relevant experience. Current and former Federal employees must include the grade level (e.g., GS-14, GS-15) for each applicable Federal position listed on their resume. Applicants seeking initial career appointment to the Senior Executive Service (SES) must include evidence of the ECQs and TQs.

PLEASE DO NOT USE USAJOBS RESUME BUILDER. 2. VACANCY QUESTION/ASSESSMENT QUESTIONNAIRE RESPONSES

Responses are automatically submitted through USA Jobs when you apply to this vacancy. Click the following link to preview the assessment: https://apply.usastaffing.gov/ViewQuestionnaire/13033126. 3.

ADDITIONAL REQUIRED DOCUMENTS

Applicants are required to submit the following supporting documentation if applicable:

CURRENT OR FORMER SES MEMBERS

Must provide your SES appointment SF-50 (Notification of Personnel Action), and an SF-50 showing current career SES status or career SES reinstatement eligibility.

SES CANDIDATE DEVELOPMENT PROGRAM

(SESCDP)

GRADUATES

Verification of successful completion of an OPM-approved SESCDP and

OPM SES QRB

certification.

CURRENT FEDERAL CIVIL SERVICE EMPLOYEE

Must provide a copy of your Notification of Personnel Action, Standard Form 50 (SF-50) or equivalent personnel action form reflecting you are a current Federal Civil Service employee.

STRONGLY RECOMMENDED

Most recent performance evaluation. There are three key documents that contain important information about your rights and obligations. Please read and retain these documents: Noncriminal Justice Applicant's Privacy Rights, for those who undergo an FBI fingerprint-based criminal history record check for personnel vetting, which includes Rap Back, FD-258 Privacy Act Statement

• FBI (this is the same statement used when your fingerprints are submitted as part of your background investigation), and SEAD-3-Reporting-U.

pdf (dni.gov), (applicable to those who hold a sensitive position or have eligibility for access to classified information)" Applicants must complete a Declaration for Federal Employment when requested by the agency to assess suitability for Federal employment. How to Apply To apply for this position, you must complete this application and submit any required documents specified in the Required Documents section and submit by 11:59 PM (EST) on 08/26/2026 to receive consideration. To begin, click Apply to access the online application. You will need to be logged into your USAJOBS account to apply. If you do not have a USAJOBS account, you will need to create one before beginning the application. Follow the prompts to select and upload your résumé and/or other required documents to be included with your application package. You will have the opportunity to upload additional documents to include in your application before it is submitted. Your uploaded documents may take several hours to clear the virus scan process. After acknowledging you have reviewed your application package, complete the "Include Personal Information" section as you deem appropriate and click to continue with the application process . You will be taken to the online application which you must complete in order to apply for the position. Complete the online application, verify the required documentation is included with your application package, and submit the application. It is applicant's responsibility to verify that information entered and uploaded, (i.e., resume and other required documents) is complete, accurate, and submitted by the closing date. Human Resources will not modify or change any part of your application. Application packages will NOT be accepted via mail. Due to security processes, mail delivery takes approximately 2-3 weeks to process at which time the vacancy announcement will be closed, and no further consideration will be given to additional application packages. Commissioned Corps Officers (including Commissioned Corps professionally boarded applicants) who are interested in applying for this position must send their cover letter and professional resume (not PHS Curriculum Vitae) to in lieu of applying through this announcement. The resume should specifically explain how you are qualified for this position and draw specific attention to your skills and experiences that demonstrate these qualifications. Also send any transcripts, licenses or certifications as requested in this announcement. Please send all documents in 1 PDF file. In the subject line of your e-mail include only the Job Announcement Number. In the body of your e-mail include your current rank name and serial number. Failure to provide this information may impact your consideration for this position. Agency contact information CMS Executive Resources Email Address Center for Program Integrity 7500 Security Blvd Woodlawn, MD 21244 US Next steps To verify the status of your application, sign in to your USAJOBS account (https://www.usajobs.gov/), all of your applications will appear on the Welcome screen. The Application Status will appear along with the date your application was last updated. For information on what each Application Status means, visit: https://help.usajobs.gov/how-to/application/status. Once your online application is submitted you will receive a confirmation notification by email. Your application will be evaluated by the Human Resources Office to determine your eligibility for the position. After the evaluation is complete, you will receive another notification regarding the status of your application. Overview Accepting applications Location 1 vacancy in the following location: Woodlawn, MD No matching locations found. Work site options Telework eligible Yes—as determined by the agency policy. Remote job No Relocation expenses reimbursed No Salary $151,661

• $228,000 per year Pay scale & grade ES 00 Promotion potential None Learn more about pay scale and grade Pay scale and grade determines the salary of the job.

Work schedule Full-time Travel Required Not required Appointment type Permanent Occupations and job series 0340 Program Management Supervisory status Yes Federal service type This job is in the Senior Executive Service Represented by a union No Drug test Yes Security clearance Top Secret Position sensitivity and risk High Risk (HR) Jobs require a background check and some require a security clearance. The type depends on the job. Background check type Credentialing Suitability/Fitness Financial disclosure required Yes Some jobs require financial disclosure to identify conflicts of interests. Announcement number

CMS-ES-26-13033126

Control number 880179100