Federal Healthcare Programs Subject Matter Expert

Position:
Federal Healthcare Programs Subject Matter Expert

Company:
Sparksoft

Location:
United States, Remote/Hybrid if local to Maryland

Employment type:
Not specified

Short Summary:
The Federal Healthcare Programs Subject Matter Expert (FHPSME) acts as a government healthcare business adviser to both the customer and the project team in all phases of the project, focusing on delivering business value in support of the Centers for Medicare & Medicaid Services (CMS).

Responsibilities:
- Provide thought leadership on the future direction of CMS Program Integrity programs and APS capabilities.
- Monitor emerging industry trends, technologies, regulations, and best practices related to healthcare fraud detection and prevention.
- Advise CMS leadership on strategic investments, modernization opportunities, and program enhancements.
- Identify opportunities to expand APS capabilities and increase value delivered to CMS stakeholders.
- Serve as a liaison and trusted partner to CMS business and system owners and key stakeholders.
- Facilitate and participate in client-facing meetings with CMS leadership and end user groups.
- Provide subject matter expertise in Federal Fraud, Waste, and Abuse (FWA) prevention, detection, investigation, and enforcement.
- Advise business and technical teams on compliance with federal healthcare regulations and CMS program integrity standards.

Requirement:
- Experience in the evaluation, administration, and oversight of federal healthcare programs, with a focus on Medicare and Medicaid.
- Comprehensive knowledge of HHS regulations, the Medicare Program Integrity Manual (PIM), and Medicare and Medicaid program operations.
- Excellent verbal and written communication skills.
- Strong analytical and problem-solving skills.
- Ability to manage multiple projects and client priorities simultaneously.
- Candidates must be able to obtain and maintain a Public Trust clearance.
- Candidates must have lived in the United States 3 out of the past 5 years.

Benefits:
- Competitive compensation and a 401(k) with employer contributions.
- Flexible paid time off and hybrid working arrangements.
- Comprehensive health coverage, including medical, dental, vision, life, and disability insurance.
- Opportunities for professional growth and development.
- A collaborative and fun culture recognized as a Great Place to Work®.