Program Manager US Office of Personnel Management
Overview
Lead administrative program integrity operations within Healthcare and Insurance division. Manage carrier compliance reviews fraud prevention audits payment integrity oversight corrective actions and develop policies to strengthen program safeguards.
What You'll Do7
- 1Own administrative program integrity reviews addressing fraud waste abuse and improper payments
- 2Lead carrier compliance oversight validating corrective actions and resolving program integrity findings
- 3Analyze trends claims data and risk indicators to identify vulnerabilities and improve detection efforts
- 4Coordinate administrative reviews referrals and corrective actions with internal and external partners
- 5Develop policies procedures and performance measures to enhance health insurance program integrity
- 6Supervise multidisciplinary workforce handling administrative reviews carrier compliance and audit resolution
- 7Drive implementation of corrective actions sanctions and contract remedies based on integrity assessments
Requirements8
- 1Must be U.S. Citizen or National born after 12-31-59 registered or exempt from Selective Service
- 2Suitable for Federal employment background investigation required
- 3Minimum 5+ years building ETL pipelines with Spark and Airflow
- 4Proven ability to coordinate cross agency programs and manage complex stakeholder relationships
- 5Strong analytical skills to interpret claims data audit results and identify program weaknesses
- 6Experience developing documentation standards referral protocols and performance measures
- 7Ability to supervise teams and provide leadership in high stakes compliance environments
- 8Commitment to public interest and efficiency of federal government operations
Salary Insight
$169 - $197k per year
Location
Required Skills
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