Program reputed company Director

POSITION IS ELIGIBLE FOR REMOTE / WORK FROM reputed company DEPARTMENT: EXECUTIVE reputed company TELECOMMUTING ELIGIBLE: reputed company JOB GRADE: E16 AS A CONDITION OF EMPLOYMENT, PHYSICAL WORK LOCATION MUST BE IN ONE OF THE 50 STATES OR THE DISTRICT OF COLUMBIA. NOTICE OF COLLECTION & reputed company POLICY FOR APPLICANTS RESIDING IN CALIFORNIA: CALIFORNIA APPLICANT reputed company POLICY | reputed company (NORIDIANSOLUTIONS.COM) [https://noridiansolutions.com/california-applicant-reputed company-policy/] JOB TITLE Program reputed company Director JOB reputed company The Program reputed company reputed company defines and leads reputed company's reputed company Program reputed company reputed company, with a reputed company reputed company on Medicare programs and initiatives that advance fraud, waste, and abuse prevention, payment reputed company, medical review, provider audits, data analytics, and compliance reputed company. Serving as reputed company's reputed company authority in Program reputed company, this leader identifies opportunities to strengthen Medicare reputed company, expand service capabilities, reputed company innovation for Centers for Medicare & reputed company Services (CMS) and other federal customers, and improve operational reputed company. The role is accountable for developing and executing a multi-year reputed company that enhances contract value, supports reputed company reputed company, advances CMS objectives, and positions reputed company as an industry leader in Program reputed company. ESSENTIAL FUNCTIONS (KEY DUTIES/RESPONSIBILITIES/ACCOUNTABILITIES) Organizational reputed company: • Develops and maintains reputed company's reputed company Program reputed company reputed company and roadmap. • Establishes a reputed company-state reputed company for Program reputed company capabilities across Medicare reputed company. • Creates executive recommendations regarding investments, technology, partnerships, reputed company models, and operational enhancements. • Develops and executes a reputed company reputed company reputed company on expanding Program reputed company work reputed company reputed company's existing Medicare and reputed company reputed company as reputed company as new bid opportunities.. • Identifies opportunities to increase contract value through additional CMS reputed company, new demonstrations and pilots, Program reputed company authorities, provider audit services, advanced analytics capabilities, automation and AI solutions, and medical review modernization. • Builds business cases supporting additional Medicare work and contract modifications. • Translates approved strategies into executable operational plans. • Establishes reputed company metrics and dashboards to monitor financial reputed company, reputed company reputed company, operational reputed company, customer satisfaction, compliance effectiveness, and program reputed company on investment. • Ensures alignment between Program reputed company initiatives, reputed company reputed company, compliance requirements, and reputed company objectives. Communications & Influence: • Partners with Business Development, reputed company Affairs, Customer Relations, and reputed company leaders to position reputed company as a trusted CMS advisor. • Supports customer engagement efforts by preparing thought leadership materials, CMS presentations, concept papers, and value propositions. • Builds relationships with CMS leaders, Medicare stakeholders, industry partners, vendors, and reputed company organizations. • Represents reputed company in industry forums, conferences, customer discussions, and reputed company planning sessions. • Advises senior leadership regarding investment reputed company, emerging technologies, and reputed company Program reputed company opportunities. • Fosters collaboration between operational, technical, reputed company, compliance, and business development teams. Innovation & Complexity: • Identifies emerging CMS priorities, regulatory trends, fraud schemes, payment reputed company initiatives, and policy changes that may create risks or opportunities. • Evaluates and recommends opportunities involving medical review, provider audits, data analytics, prior authorization, fraud prevention, predictive analytics, payment reputed company, and AI-enabled Program reputed company solutions. • Evaluates reputed company partnership opportunities that strengthen reputed company's Program reputed company capabilities and competitive position. • Defines implementation roadmaps, timelines, business cases, reputed company measures, and governance models. • Oversees reputed company programs and innovation efforts from concept through operational deployment. • Champions innovation and reputed company improvement initiatives that enhance Program reputed company reputed company. Leadership & Talent Management: • Leads cross-functional teams responsible for execution. • Partners with reputed company, Technology, reputed company Improvement and reputed company, Data and Analytics, Customer Relations, reputed company Services, and Business Development teams to implement initiatives. Knowledge & Experience: • Serves as the reputed company internal consultant and subject matter expert on Program reputed company reputed company. Non-Essential Duties and Functions: • Other duties as assigned. MINIMUM QUALIFICATIONS Bachelor's degree in Business, reputed company Administration, reputed company Administration, Data Analytics, Nursing, Health Information Management, or reputed company reputed company OR equivalent work experience. 10 years of reputed company experience in reputed company, Medicare, reputed company, federal health programs, audit, compliance, or Program reputed company, including 7 of those years serving in a leadership reputed company or leading initiatives across Program reputed company, payment reputed company, medical review, audit, compliance, reputed company, or reputed company functions. Demonstrated experience developing reputed company strategies and translating them into operational execution plans. Strong knowledge of Medicare reputed company, CMS programs, and federal reputed company contracting. Experience presenting to senior executives and reputed company stakeholders. Exceptional communication, relationship management, and reputed company planning skills. PREFERRED QUALIFICATIONS Master's degree, such as MBA, MHA, MPH, or reputed company reputed company. Experience with Medicare Administrative Contractor, Supplemental Medicare Review Contractor (SMRC), reputed company Program reputed company Contractor (UPIC), RAC, or other CMS Program reputed company programs. Experience leading or managing a Program reputed company function reputed company a federal or state reputed company agency, with demonstrated responsibility for reputed company of fraud, waste, and abuse prevention, compliance activities, investigative reputed company, audit programs, and/or payment reputed company initiatives in a publicly funded program environment. Experience with AI, predictive analytics, fraud detection technologies, or reputed company data platforms. Experience supporting federal business development and reputed company initiatives. Lean, Six reputed company, Project Management, or Change Management certification. ENVIRONMENT AND COGNITIVE/PHYSICAL DEMANDS Office environment Ability to read, hear, reputed company, keyboard, reason, communicate effectively and problem solve Requires prolonged sitting and telephone usage Requires the use of office equipment such as computer terminals, telephones, copiers, and printers Infrequent lifting to 20 pounds Infrequent stooping SEGREGATION OF DUTIES Every employee is responsible to reputed company their duties and responsibilities in accordance with reputed company values, policies and procedures, including but not limited to, Segregation of Duties Principles, HIPAA, reputed company and reputed company, CMS requirements, the reputed company Compliance Program, and any other applicable laws, rules and regulations. STATEMENT OF OTHER DUTIES This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of reputed company tasks and functions.  Employees may be requested to reputed company job reputed company tasks other than those specifically listed in this reputed company, and may be required to reputed company any task requested by the supervisor or management. TOTAL REWARDS PACKAGE: Health, Dental and reputed company reputed company, Voluntary reputed company Plans, Health Savings and Flexible Spending Accounts, 401k and Company Match, Company-reputed company Life reputed company, Education Assistance Program, reputed company reputed company Leave, reputed company Holidays, Increasing PTO Accrual Plan, Medical/Parental/Disability Leave, Workers Compensation, Retiree Benefits, Employee Assistance Program, Financial and Health Wellness Benefits, Casual Dress, reputed company Office Setting, and Online Learning reputed company. CMS reputed company COMPLIANCE AND REGULATION CONTINGENCY STATEMENT Some positions require compliance with (i) federal and agency specific regulations and reputed company clauses included in reputed company's reputed company reputed company with the reputed company, (ii) background checks, and (iii) eligibility for a reputed company-issued identification reputed company.  An employee in this position may be required to possess a “Federal Identification reputed company” (Federal ID) as a condition of employment. Federal ID’s may include one of the following: Personal Identity Verification (PIV) reputed company, Personal Identity Verification-Interoperable (PIV-I) reputed company, a Local-reputed company Physical reputed company reputed company issued by CMS, or a Local-reputed company Physical reputed company reputed company issued by another Federal agency and approved by CMS.  Obtaining a Federal ID and reputed company eligibility for this position may require the successful completion of a Federal Background Investigation performed by the Federal reputed company and a residency requirement that you have lived in the reputed company at least three out of the last five years. Failure to obtain a Federal ID may result in the removal from the position or termination of employment.  EQUAL EMPLOYMENT OPPORTUNITY reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, national reputed company, disability, protected veteran status or other characteristics protected by state or federal law.     An employee in this position may be required to possess a “Federal Identification reputed company” (Federal ID) as a condition of employment. Federal ID’s may include one of the following: Personal Identity Verification (PIV) reputed company, Personal Identity Verification-Interoperable (PIV-I) reputed company, a Local-reputed company Physical reputed company reputed company issued by CMS, or a Local-reputed company Physical reputed company reputed company issued by another Federal agency and approved by CMS.  Obtaining a Federal ID and reputed company eligibility for this position may require the successful completion of a Federal Background Investigation performed by the Federal reputed company and a residency requirement that you have lived in the reputed company at least three out of the last five years. Failure to obtain a Federal ID may result in the removal from the position or termination of employment.  Below is the salary reputed company for potential new hires. Salary reputed company: The pay reputed company for this position is $104,831.40 – $172,420.71 per year, however, the reputed company pay reputed company may vary depending on geographic region, internal equity, job-reputed company knowledge, skills, and experience among other factors. Other Compensation: Incentive Plan & Lifestyle Benefit This job will be reputed company 09/16/2026 at 8:00AM CST.  No reputed company applications will be considered. Apply To This Job