Marketplace Lead Supervisor

Clearance Level
None
Category
Project/Task Management
Locations
Remote, Based in USA
Remote, Based in District of Columbia
Martinsburg, Pennsylvania
Remote, Based in West Virginia

REQ#: RQ103251

Travel Required: Less than 10%
Requisition Type: Regular

GDIT is searching for a Marketplace Lead Supervisor to support the Center for Medicare & Medicaid Services’ (CMS) mission to detect and combat potential fraud, waste, and abuse of the Medicare, Medicaid and Marketplace programs. GDIT works with CMS to safeguard the integrity of health insurance marketplaces authorized by the Affordable Care Act (ACA). Our work focuses on protecting consumers while also minimizing unnecessary burden on legitimate enrollments. Through research, investigation and data analysis, the desired outcomes of our efforts are to prevent, detect, and resolve noncompliance with Medicare rules, requirements, and law and recommend administrative action to CMS.

Responsibilities

  • Manage the intake, prioritization, screening and investigation of leads and conduct research, data analysis, and investigative activities to assess compliance with ACA requirements and regulations

  • Oversee two to four leads management analysts in their daily activities and coordinate with other team members as needed

  • Present task status and activities and make recommendations for education actions to CMS

  • Delivery of high quality and timely work products and reports to leadership and our customer on activities, accomplishments, issues, and innovations

  • Develop and maintain CMS-approved SOPs as to how to conduct fraud, waste and abuse (FWA) lead reviews and investigations and have input into recommendations for SOP updates as needed.

  • Within a case management system, comprehensively document in detail all lead and investigation activity and recommendations to CMS.

  • Train team members on processes and procedures

  • Other duties as assigned

  • Safeguard PII and PHI

  • Infrequent travel may be required

Qualifications

  • Bachelor’s degree or equivalency in regulatory or investigative field that includes 2-4 years of ACA experience

  • Highly organized, ability to multi-task and meet deadlines

  • Proficient in computer skills, e.g., Microsoft Office-Word, Excel

  • Strong inter-personal and communications skills, both written and oral

  • Ability to conceptualize, solve problems, and draw conclusions

  • Comfortable with large data sets, identifying patterns, and identifying potential anomalies

Value-Add Experience

  • Experience with Marketplace Insurance programs

  • Experience with FWA and investigations of healthcare fraud

  • Experience with JIRA or other case management systems

This position requires being fully vaccinated against COVID-19 by January 18, 2022 or the start date, if after January 18. Individuals who work in or reside in Florida, Montana, Tennessee, Texas, or work outside of the United States may be excluded from this requirement.

The likely salary range for this position is $72,000 - $108,000, this is not, however, a guarantee of compensation or salary; rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.

View information about benefits and our total rewards program.

We are GDIT. The people supporting some of the most complex government, defense, and intelligence projects across the country. We deliver. Bringing the expertise needed to understand and advance critical missions. We transform. Shifting the ways clients invest in, integrate, and innovate technology solutions. We ensure today is safe and tomorrow is smarter. We are there. On the ground, beside our clients, in the lab, and everywhere in between. Offering the technology transformations, strategy, and mission services needed to get the job done.

GDIT is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other protected class.