Summary
This position is in the Centers for Medicare and Medicaid Services (CMS), Center for Program Integrity (CPI).
As the Director of the Data Analytics and Systems Group (DASG), you will provide executive leadership, direction, and coordination for comprehensive analytics strategies, including providing statistical and data analysis for Program Integrity (PI) issues, as well as identifying emerging fraud trends through data mining and other analytical techniques.
This job is open to
Clarification from the agency
All groups of qualified individuals.
Duties
- Promotes integrity in Medicare and Medicaid Programs by developing a national fraud prevention program for payments and provider enrollment, integrating predictive modeling into CMS’ claims processing and provider enrollment system
- Serves as an effective change agent to achieve quality improvement within PI by using data to quickly identify vulnerabilities and areas for action/improvement and planning and re-measuring to ensure effective improvement actions.
- Achieves quality improvement within PI by utilizing technology to analyze datasets to identify patterns and networks that represent a high risk of fraudulent activity and analyzing processes to determine the root cause of such vulnerabilities.
- Oversees the development and maintenance of IT platforms and data access methodologies for detection of fraud and abuse.
- Develops and manages ROI methodologies to report savings associated with fraud prevention systems.
- Develops and maintains Information Technology platforms and data access methodologies for detection of fraud and abuse.
- Exercises executive leadership in the development, vision, strategy, oversight, and implementation of the Agency’s major fraud fighting tools.
- Provides oversight of the development of clinical and data-driven algorithms that run in the IT systems used to detect fraud.
Requirements
Conditions of Employment
- U.S. Citizenship required.
- Background and/or Security Investigation required.
- One year SES probationary period required.
- The Ethics in Government Act, PL 95-521 requires the applicant selected for this position to submit a financial disclosure statement, SF-278, prior to assuming the SES position, annually, and upon termination of employment.
- Status applicants must submit a copy of their most recent SF-50, Notification of Personnel Action, which verifies status.
- All initial appointments to an SES position are contingent on approval from OPM's Qualifications Review Board unless the selectee has successfully participated in an OPM approved SES Candidate Development Program.
- All male applicants born after December 31, 1959, must have registered for the selective service. You will be required to sign a statement certifying his registration, or the applicant must demonstrate exempt status under the Selective Service Law.
- Only experience obtained by the closing date of this announcement will be considered.
Qualifications
All competitive candidates for SES positions with the Federal Government must demonstrate leadership experience indicative of senior executive level management capability. To meet the minimum qualification requirements for this position, you must show in your resume that you possess the Fundamental Competencies, five Executive Core Qualifications, and the Professional/Technical Qualifications listed below. Evidence of this experience must be incorporated into your five page resume. Separate narratives for the Executive Core Qualifications and/or Professional/Technical Qualifications will not be accepted or considered. Typically, experience of this nature is gained at or above the GS-15 grade level in the Federal service, or its equivalent with state or local government, the private sector, or nongovernmental organizations.
Fundamental Competencies:
Interpersonal Skills, Oral Communication, Integrity/Honesty, Written Communication, Continual Learning, and Public Service Motivation.
Executive Core Qualifications (ECQs)
- Leading Change: The ability to bring about strategic change, both within and outside the organization, to meet organizational goals. Inherent to this ECQ is the ability to establish an organizational vision and to implement it in a continuously changing environment.
- Leading People: The ability to lead people toward meeting the organization's vision, mission, and goals. Inherent to this ECQ is the ability to provide an inclusive workplace that fosters the development of others, facilitates cooperation and teamwork, and supports constructive resolution of conflicts.
- Results Driven: The ability to meet organizational goals and customer expectations. Inherent to this ECQ is the ability to make decisions that produce high-quality results by applying technical knowledge, analyzing problems, and calculating risks.
- Business Acumen: The ability to manage human, financial, and information resources strategically.
- Building Coalitions: The ability to build coalitions internally and with other Federal agencies, State and local governments, nonprofit and private sector organizations, foreign governments, or international organizations to achieve common goals.
Professional/Technical Qualifications (PTQs)
This position also requires that you possess PTQs that represent knowledge, skills, and abilities essential for success in this role. The following PTQs must be evident in your resume.
- Demonstrated experience in a senior leadership position, dealing and negotiating with a wide range of senior-level information technology (IT) officials in various government agencies, law enforcement organizations, or public and private organizations regarding complex and controversial issues concerning federal programs and the protection of the integrity of these programs.
- Demonstrated experience in the development and implementation of Program Integrity (PI) prevention and detection initiatives into large-scale IT platforms for the identification of major fraud, waste, and abuse trends.
- Demonstrated experience in developing and implementing a national fraud prevention IT system that integrates predictive analytics.
- Demonstrated experience building high-performing teams of IT professionals.
- Demonstrated experience developing and implementing an organizational-wide IT workforce strategy that attracts, develops, and retains top IT, digital, and cybersecurity talent to continuously analyze and adopt modern technologies, solutions, and processes that drive enhanced business value.
It is STRONGLY recommended that you visit the following Office of Personnel Management (OPM) webpage for more information regarding the Fundamental Competencies and ECQs.
https://www.opm.gov/policy-data-oversight/senior-executive-service/executive-core-qualifications/#url=Overview
If selected, you will be required to complete an ECQ package by drafting narratives for each of the ECQs for submission and certification by an OPM Qualifications Review Board (QRB) in order to be placed in this position. If you are currently serving in a career SES appointment, are eligible for reinstatement into the SES, or have successfully completed an SES Candidate Development Program approved by the Office of Personnel Management (OPM), you will not need to draft the ECQs.
Education
This job does not have an education qualification requirement.
Benefits
A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
Review our benefits
Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.
How You Will Be Evaluated
You will be evaluated for this job based on how well you meet the qualifications above.
We use a multi-step process to evaluate and refer applicants:
- Minimum requirements: Your application must show that you meet all requirements, including the education and/or experience required for this position. You may be found 'not qualified' if you do not possess the minimum competencies required for the position. If your application is incomplete, we may rate you as ineligible.
- Rating: A panel of Senior Executives will review your application and evaluate your qualification for this position based on the information in your application. Your application will be rated, based on the extent and quality of your experience, education, and training relevant to the duties of this position. Interviews will be at the discretion of the panel and/or selection official.
- Referral: If you are among the top qualified candidates, your application will be referred to a selection official for consideration and possible interview.
Required Documents
All applicants are required to submit and/or complete the following documents to be considered for the position:
- Resume that contains your full name, address and phone number, and does not exceed the five page limit;
- Cover Letter (optional);
- Online Assessment Questionnaire. To preview the assessment questionnaire, click here: https://apply.usastaffing.gov/ViewQuestionnaire/12409656
NOTE: THE USAJOBS RESUME TEMPLATE MAY RESULT IN A RESUME BEING LONGER THAN FIVE PAGES. PLEASE VERIFY PAGE LENGTH BEFORE SUBMISSION OF APPLICATION.
Applicants who are currently, or were previously, Federal employees must also submit:
- An SF-50 showing your current or former civil service status; and
- Proof of OPM Qualifications Review Board certification (OPM-approved SES Candidate Development Program graduates), if applicable.
NOTE: Documents submitted that are not listed in the Required Documents section of this announcement will not be considered or forwarded to the rating panel or selecting official.
How to Apply
The application process used to recruit for this position is the RESUME BASED method. Although applicants cannot address the ECQs or PTQs separately, evidence of each must be clearly demonstrated in the five page resume and throughout the rest of the application package.
To be considered for this position, you must submit a complete application no later than 11:59 PM (Eastern Time) on the closing date of the announcement - 06/29/2024. If you fail to submit a complete application prior to the closing time, the application system will not allow you to finish. Requests for extensions will not be granted, so please begin the application process with enough time to finish before the deadline.
ALL APPLICANTS (including Commissioned Corps Officers): You must submit a resume (five-page maximum - resumes that exceed the five-page limit will not be considered). You may also submit an optional cover letter. Separate written narratives addressing the ECQs and PTQs will not be considered.
You must complete the online assessment questions. If your resume does not support the responses in your questionnaire, you may be rated "ineligible." We recommend that your resume emphasize your level of responsibilities, the scope and complexity of the programs managed, and your program accomplishments, including the results of your actions.
Your five page resume should include the following:
- Job Information (Announcement number and title of job for which you are applying)
- Personal Information (Full name, mailing address, work and home phone number and email addresses)
- Education (College/University name, city and state, major, type and year of degree)
- Work Experience (Job title (including series and grade, if Federal employment, duties and accomplishments, employer's name and address, start and end dates (month and year), hours per week, and salary)
- Evidence of experience which addresses the five ECQs and the PTQs.
- Other qualifications (Job-related training courses (title and year), skills, certifications and licenses, honors, awards, and special accomplishments).
It is important that your resume be complete and thorough. Please be sure to include and address all ECQs and PTQs in your resume. A sample five-page resume that incorporates the ECQs can be found in OPM's Guide to Senior Executive Service Qualifications: https://www.opm.gov/policy-data-oversight/senior-executive-service/reference-materials/guidetosesquals_2012.pdf
Steps to submit a complete application:
- You must have a USAJobs account and be logged in.
- Once you are logged in and all of your application materials are ready, click the "Apply" button.
- You must respond to all application assessment questions, carefully following the instructions provided. To preview the questions, click here: https://apply.usastaffing.gov/ViewQuestionnaire/12409656
- You will then be asked to upload your resume and optional cover letter. Additional documentation not listed in the Required Documents will not be considered.
Next steps
You will receive an email informing you of the receipt of your application. Applicants who are determined to be highly qualified by the SES rating panel will be referred to the selecting official for further consideration and possible interview, at which time you will be contacted. All applicants will be notified of the outcome of their applications once a final selection is made.
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