About this role
Job SummaryThis position is located in the Chronic Care Policy Group in the Center for Medicare within CMS in Baltimore, Maryland. As the Director, you will provide executive leadership, direction, and coordination for the development and evaluation of national Medicare policies and standards on the benefit structure and payment methods for services provided by a variety of Medicare providers.
QualificationsCandidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution. Candidates will not be hired based on their race, sex, color, religion, or national origin. To meet the minimum qualification requirements for this position, you must show that you possess the Executive Core Qualifications (ECQ) and Technical Qualifications (TQ) related to this position within your resume - NOT TO EXCEED 2 PAGES. Resumes over the 2-page limit, will not be reviewed beyond page 2 or may be disqualified. Your resume should include examples of experience, education, and accomplishments applicable to the qualification(s). If your resume does not reflect demonstrated evidence of these qualifications, you may not receive consideration for the position. There is NO requirement to prepare a narrative statement specifically addressing the Executive Core Qualifications (ECQs) or the Technical Qualifications (TQs). TECHNICAL QUALIFICATIONS (TQs): Your resume should demonstrate accomplishments that would satisfy the technical qualifications. TQ 1: Knowledge and experience in successfully developing payment or pricing strategies and rules for large-scale national, private health insurance, or public health programs to improve program effectiveness and achieve measurable organizational or programmatic results. TQ 2: Demonstrated leadership experience directing highly skilled, multidisciplinary professional staff on high-profile initiatives within a large-scale national, private health insurance, or public health program EXECUTIVE CORE QUALIFICATIONS (ECQs): In addition to the Technical Qualification Requirements listed above, all new entrants into the Senior Executive Service (SES) under a career appointment will be assessed for executive competency against the following five mandatory ECQs. If your 2-page resume does not reflect demonstrated evidence of the ECQs and TQs, you may not receive further consideration for the position. There are five ECQs: ECQ 1: Commitment to the Rule of Law and the Principles of the American Founding - This core qualification requires a demonstrated knowledge of the American system of government, commitment to uphold the Constitution and the rule of law, and commitment to serve the American people. ECQ 2: Driving Efficiency - This core qualification involves the demonstrated ability to strategically and efficiently manage resources, budget effectively, cut wasteful spending, and pursue efficiency through process and technological upgrades. ECQ 3: Merit and Competence - This core qualification involves the demonstrated knowledge, ability and technical competence to effectively and reliably produce work that is of exceptional quality. ECQ 4: Leading People - This core qualification involves the demonstrated ability to lead and inspire a group toward meeting the organization's vision, mission, and goals, and to drive a high-performance, high-accountability culture. This includes, when necessary, the ability to lead people through change and to hold individuals accountable. ECQ 5: Achieving Results - This core qualification involves the demonstrated ability to achieve both individual and organizational results, and to align results to stated goals from superiors. Note: If you are a member of the SES or have been certified through successful participation in an OPM approved SES Candidate Development Program (SESCDP), or have SES reinstatement eligibility, you do not need to respond to the ECQs. Instead, you should attach proof (e.g., SF-50, Certification by OPM's SES Qualifications Review Board (QRB)) of your eligibility for noncompetitive appointment to the SES.
Major DutiesLeading the development of methodologies to modify payment systems/adjust payments based on statutory/regulatory criteria for home health and hospice providers, skilled nursing and inpatient rehabilitation facilities, dialysis facilities, and others.Annually updating payment systems for these provider types through rulemaking in accordance with law, regulations, and Administration priorities.Developing and evaluating national policies, regulations and instructions for cost reporting and payment/reimbursement of the reasonable costs incurred by critical access hospitals and certain other providers under the Medicare program.Interpreting law and developing policy directives and basic payment policy decision statements.Developing and evaluating policies under the Physician Self-Referral law and coordinating with the Office of Inspector General and other Federal agencies regarding oversight and enforcement.Maintaining continuing liaison with provider groups, industry associations, patient organizations, medical associations, and other parties that relate to assigned subject areas.