Program Director – Federal Health

This is a fully remote position, open to applicants in Virginia.

📋 Description

• Act as the primary and accountable liaison for CMS, including the Contracting Officer Representative (COR) and Contracting Officer (CO), regarding all contract-related issues.

• Manage contractual delivery schedules and guarantee timely submission of deliverables, reports, and performance data as stipulated in the SOW.

• Lead and direct a diverse team of over 100 professionals, encompassing clinical reviewers, medical coders, customer service representatives, and IT personnel.

• Supervise recruitment, training, performance evaluation, and workforce planning activities.

• Ensure adherence to contractual performance standards and address operational challenges promptly.

• Oversee the creation and submission of mandatory CMS reports, data deliverables, and updates on program status.

• Facilitate contract initiation activities, transition planning, and relationship management with CMS stakeholders.

• Manage operations related to Medicare Part A/B/DMEPOS claim reviews, workflow design, case management systems, and quality assurance processes.

• Govern subcontractor relationships and performance in accordance with prime contract stipulations.

• Advocate for compliance, precision, and ongoing enhancement throughout program operations.

⛳️ Requirements

• At least 5 years of professional experience in healthcare program management, federal contracting, or a similar domain.

• A minimum of 3 years of experience in managing complex systems and workflows in a managerial or supervisory capacity.

• At least 3 years of experience in Medicare Fee-for-Service (FFS) program operations.

• Proven experience in managing teams of 100 or more personnel within a federal healthcare contracting environment.

• Bachelor’s degree is required.

• Master’s degree is preferred.

• Previous experience as a Program Director on a CMS medical review contract is preferred.

• Operational knowledge of Medicare Part A, Part B, and DMEPOS claim review processes and adjudication workflows.

• Familiarity with CMS reporting schedules, contract initiation procedures, and the COR/CO relationship framework in a federal contracting context.

• Capability to sit, read, work on a computer, and view a computer screen for extended durations.

• Occasionally able to stand, walk, use hands and fingers, kneel or crouch.

🏝️ Benefits

• Reasonable accommodations may be provided to enable individuals with disabilities to perform essential functions.

• Equal employment opportunity employer.

• Equal employment opportunities for individuals with disabilities.