[Remote] Medicare/Medicaid Program Integrity Advisor

Note: The job is a remote job and is open to candidates in USA. USmax Corporation is an award-winning SBA Certified Woman-Owned Small Business providing innovative professional, technical, and enterprise IT services. They are seeking a Medicare/Medicaid Program Integrity Advisor to support the U.S. Department of Health and Human Services by developing educational and outreach materials for fraud, waste, and abuse, while ensuring compliance with CMS guidance and regulations.ResponsibilitiesPerform a thorough review of peer submissions to ensure submission quality and compliance with current CMS guidance and regulationsServe as the Program Integrity subject matter expert and provide guidance on CMS PI-related questions and initiativesStay current with emerging CMS PI guidance, industry expectations, and standards, and demonstrate the ability to translate these into educational materials for CPI stakeholdersResearch and interpret CMS regulations, guidance, manuals, and policy updatesProvide expert consultation regarding Program Integrity initiativesReview educational content for technical accuracyIdentify emerging fraud schemes and vulnerabilitiesRecommend outreach and training strategiesParticipate in stakeholder meetings and workgroupsSupport development of fact sheets, toolkits, webinars, and training productsOther duties as assignedSkillsProficient in Microsoft Office Applications (Microsoft Outlook, Word, Excel, PowerPoint, and SharePoint); advanced knowledge of Excel formulas preferredExcellent verbal and written communication and presentation skillsAbility to proactively anticipate project needs, support project strategy and implementationOrganized, detail-oriented, self-motivated, efficient, flexible, and able to meet deadlinesExperience executing in a high-paced, evolving environment with short deadlinesAbility to comprehend and provide analysis of deliverables and related customer-facing materialsAbility to demonstrate sound judgment, attention to detail, and critical thinkingAbility to work independently(5) years minimum experience supporting Medicare, Medicaid, or healthcare Program Integrity initiativesThorough understanding of CMS Program Integrity regulations, Medicare and Medicaid guidance, policy directives, and related federal requirementsDemonstrated expertise in CMS Program Integrity operations and policyBachelor's degreeSeven to ten years supporting CMS CPI initiativesFive years reviewing policy and regulatory guidanceCompany OverviewUSmax Corporation is an ISO 9001:2015 registered, ISO 20000:2011 registered, ISO 27001:2013 registered, and CMMI-SVC Level 3 appraised Enterprise Information Technology (IT) and Professional Services firm. It was founded in 2017, and is headquartered in Gambrills, Maryland, USA, with a workforce of 51-200 employees. Its website is https://www.usmax.com.