This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Program Integrity, Fraud Investigations Group (FIG), Division of Field Operations - North (DFON) . As a Nurse (Program Vulnerability Detection & Prevention), GS-0610-13, you will provide authoritative clinical and nursing advice along with guidance as part of CMS program policy or supports team.

Duties

Develop guidelines and procedures for the review of clinical data to determine whether patients and beneficiaries are receiving medically necessary care and appropriate levels of service. Interpret legislation, regulations, CMS policies, and procedures to facilitate consistency in their application among Medicare contractors. Lead significant projects and initiatives that impact program integrity operations across the country. Speak on behalf of CMS leadership on technical matters associated with program integrity efforts within the incumbents purview.

Requirements

• You must be a U.S. Citizen or National to apply for this position.
• You will be subject to a background and suitability investigation.

Qualifications

ALL QUALIFICATION REQUIREMENTS MUST BE MET BY THE CLOSING DATE OF THIS ANNOUNCEMENT. Your resume must include detailed information as it relates to the responsibilities and specialized experience for this position. Evidence of copying and pasting directly from the vacancy announcement without clearly documenting supplemental information to describe your experience will result in an ineligible rating. This will prevent you from receiving further consideration. BASIC REQUIREMENT(S): Education: A graduate or higher level degree, bachelor's degree, associate degree, or diploma from an accredited professional nursing educational program is required. This education must have been accredited by the Commission on Collegiate Nursing Education (external link), Council on Accreditation of Nurse Anesthesia Educational Programs (external link), Accreditation Commission for Midwifery Education (external link), or an accrediting body recognized by the U.S. Department of Education (external link) at the time the degree was obtained. Degree from Foreign Nursing School: Official certification from the Commission on Graduates of Foreign Nursing Schools (external link) is required for individuals who graduated from foreign nursing schools. Licensure: For all grade levels for this position, you must have passed the National Council Licensure Examination (external link). In addition, you must possess a current, active, full, and unrestricted license or registration as a professional nurse from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community, student, social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.

Education

Education Requirement: In addition to meeting the qualification requirements, all candidates must have the following educational requirements: A graduate or higher level degree, bachelor's degree, associate degree, or diploma from an accredited professional nursing educational program is required. This education must have been accredited by the Commission on Collegiate Nursing Education (external link), Council on Accreditation of Nurse Anesthesia Educational Programs (external link), Accreditation Commission for Midwifery Education (external link), or an accrediting body recognized by the U.S. Department of Education (external link) at the time the degree was obtained.

TRANSCRIPTS are required to verify satisfactory completion of the educational requirement listed above. Failure to submit a copy of your transcripts at the time of application WILL result in an ineligible rating. Please see "Required Documents" section below for what documentation is required at the time of application.

Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/12067539

Contacts

• Address Center for Program Integrity 7500 Security Blvd Woodlawn, MD 21244 US
• Name: CMS HR Inquiries
• Email: [email protected]