Senior Program Review Specialist

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

📋 Description

• Oversee comprehensive evaluations of applications, submissions, or case files utilizing established policies, procedures, templates, and evaluation standards.

• Evaluate eligibility, program compatibility, documentation thoroughness, internal coherence, and the reliability of supporting evidence.

• Create review records that detail the evidence reviewed, conclusions drawn, unresolved matters, and the rationale behind recommendations.

• Design and sustain standardized review checklists, decision trees, evidence matrices, and tools for reviewers.

• Identify absent, ambiguous, or contradictory information and manage clarification requests through communication with applicants.

• Ensure that conclusions are traceable to governing regulations and differentiate between factual findings and professional judgments or suggestions.

• Perform secondary reviews of intricate, sensitive, or borderline cases and escalate interpretative queries as needed.

• Facilitate reviewer calibration meetings to enhance consistency, minimize rework, and document guidance or precedents.

• Analyze persistent deficiencies and propose modifications to intake instructions, templates, standard operating procedures (SOPs), and quality controls.

• Safeguard applicant information and maintain precise records in the designated document repository and tracking system.

⛳️ Requirements

• Bachelor’s degree in public policy, healthcare administration, business administration, social sciences, law, compliance, or a related discipline.

• At least 5 years of experience conducting technical, eligibility, compliance, policy, or documentation reviews.

• Capability to interpret laws, regulations, policies, or program requirements and apply them consistently to specific cases.

• Experience in evaluating evidence, documenting conclusions, and crafting defensible written recommendations.

• Exceptional attention to detail with the ability to pinpoint gaps, discrepancies, and unsupported assertions.

• Strong writing abilities and the capacity to clearly convey review findings to both technical and non-technical audiences.

• Proficient in handling a consistent volume of tasks while meeting turnaround and quality expectations.

• Legal authorization to work in the U.S.

• Preferred: Experience assisting VA, federal health agencies, Veterans’ programs, healthcare navigation, public benefits, or community collaborations.

• Preferred: Experience reviewing nonprofit, volunteer, community-based, healthcare, or public-service organizations.

• Preferred: Experience with credentialing, certification, eligibility, licensing, grants, claims, or formal application-review processes.

• Preferred: Experience in developing review rubrics, checklists, standard work, or knowledge-management resources.

• Preferred: Familiarity with Lean methods, reviewer calibration, and root-cause analysis.

🏝️ Benefits

• Equal opportunity employer.

• Veterans, members of the Reserve and National Guard, and transitioning active-duty service members are strongly encouraged to apply.

• Notifications for Talent Community members regarding new job opportunities, company updates, and upcoming career events.