Positions at CMS
Health Insurance Specialists develop, interpret and implement health care financing policy and affect the disbursement of billions of dollars each year. Among other things, they also analyze Medicare and Medicaid policies, identify trends in health care utilization, study the private health insurance industry, and participate in inspections and program evaluations.
Information Technology Specialists design and implement computer systems which aid research efforts, policy development and employee performance. They often work with other Federal and State Government agencies and outside organizations to coordinate the Medicare and Medicaid computer systems. Information technology specialists also program and analyze improvements in systems' applications.
Social Science Research Analysts conduct research and test new policies and processes designed to improve program operation.
Management Analysts focus on CMS's internal operations with the goal of improving organizational effectiveness. In particular, they focus on the administrative feasibility and implementation of laws, regulations, and policies. In doing so, management analysts design information systems; institute productivity improvements; provide advice on organizational structure and work methods; and prevent fraud, waste, and abuse.
Economists at CMS research and interpret economic data related to CMS programs. They also help design, implement, and evaluate Medicare and Medicaid demonstrations as well as related quality assurance projects. Please see our detailed description below.
Actuaries use mathematics and statistics to analyze and provide cost estimates concerning the financing of Medicare, Medicaid, and related modifications to these programs. Please see our detailed description below.
Health Insurance Specialists monitor and evaluate state Medicaid programs for compliance with Federal regulations. Staff provides advice about the law, regulations, and policy in such issue areas as eligibility, coverage and payment. They also monitor and evaluate the work of organizations that contract with Medicare. These employees strive to ensure compliance with provisions of the contract, the law and Federal regulations.
Survey and Certification Specialists offer technical assistance to State certification agencies. This assistance relates to Medicare and Medicaid activities that affect the delivery of health care. Survey and certification specialists also review and assess the quality of health care delivered by Medicare and Medicaid providers. Among the health professionals in this specialty are nurses, medical technologists, dieticians, and pharmacists.
Nurse Consultants review, analyze and evaluate the effectiveness and quality of services delivered by Medicare and Medicaid providers.
Medical Technologists conduct reviews of laboratories for Federal monitoring and laboratory certification purposes. They also provide technical assistance to State certification agencies.
Managed Care Specialists coordinate, implement and monitor overall operations of managed care health plans (i.e., Health Maintenance Organizations, Competitive Medical Plans, and Health Care Prepayment Plans), and Federally qualified Health Maintenance Organizations. They ensure that the health care program results in an appropriate and adequate level of medical service delivery to Medicare enrollees. These responsibilities include performing functions related to the qualification and compliance of Medicare contracting and Federally qualified managed health care plans with the requirements of Federal laws, regulations and other mandated guidelines.
In addition to these headquarters and regional office positions, CMS's success also depends on the abilities and contributions of others such as:
- Financial Management Specialists
- Budget Analysts
- Medical Officers
- Public Affairs Specialists
- Video and Graphics Production Specialists;
- and Writers/Editors
The Office of the Actuary assists the Agency by providing timely, impartial and authoritative estimates and analysis of health care financing and spending. Currently, the Office of the Actuary at CMS is looking to fill actuarial positions in the following three areas:
- Health Actuary – The Office of the Actuary is involved in implementing the new Medicare prescription drug benefit and the Medicare Advantage program. We are looking for candidates with health experience, especially in the areas of prescription drug benefits and/or private health plans.
- Pension Actuary – The Office of the Actuary is involved in reviewing and analyzing pension and other employee benefit plans of Medicare contractors and providers. We are looking for a candidate with experience working with pension plans and ERISA; EA designation preferred. Knowledge of and experience with SFAS 87, 88 and 106 and the Federal Procurement Regulations is a plus.
- Entry-level and mid-level Actuaries – The Office of the Actuary is responsible for projecting expenditures for the Medicare and Medicaid baselines in the President's budget, preparing estimates on the financial operations of the Medicare Trust Funds, promulgating various program rates, and providing estimated impacts of proposed changes to the Medicare and Medicaid programs. We are looking for candidates to work on the development of these estimates, and are considering entry-level candidates and candidates with less than 3 years experience for these positions.
The basic requirements for actuaries is a Bachelors degree with a concentration in mathematics that includes courses in actuarial science, mathematics, and relevant statistics totaling at least 24 semester hours or a combination of education and experience which includes completion of at least Course 1, 2, or 3 of the Society of Actuaries exams.
The Office of the Actuary is also looking to fill economist positions as well. Currently, the Office of the Actuary at CMS is looking to fill economist positions in the following three areas:
- Long-Range Health Sector Modeling – The Office of the Actuary is developing the capability to produce 75-year and infinite horizon projections of U.S. health spending. We are looking for candidates with applied experienced in health sector and/or macroeconomic modeling.
- Price Index Development – The Office of the Actuary is responsible for developing and maintaining price indexes used to annually update provider payments for Medicare services. We are looking for candidates with experience in developing price indexes and/or background in health or macroeconomic modeling.
- National Health Accounting – The Office of the Actuary is responsible for the development of the official U.S. government statistics on U.S. health spending by type of service and source of funding. We are looking for candidates to work on the development of these estimates, and are considering entry-level candidates and candidates with experience in income accounting and health care cost estimation.
The basic requirements for economists is a degree in economics that includes at least 21 semester hours in economics and 3 semester hours in statistics, accounting, or calculus or a combination of education and experience -- courses equivalent to a major in economics plus appropriate experience or additional education.
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