Job Information
Serco Federal Health Insurance Marketplace Program Auditor in Virginia
Position Description
Serco is seekinga motivatedFederalHealth InsuranceMarketplace Program Auditor to join our talented and fast-paced Public Sector Solutions team, which supports federal programsassistingmillions of people seeking government health coverage. This dynamic position will primarily work on the CMS Eligibility Support (ES) Contract toensureprogramand regulatorycompliancethrough internalaudits and supportCMSonexternalauditswith the Office of the Inspector General, Government Accountability Office, andvarious CMSprogram integrityoffices.The candidate willapply auditing techniques and analytical skills to evaluateprogramoperationsin accordancewithFederal Health InsuranceMarketplaceeligibilityregulationsandidentifyrisks, mitigations, andareas for improvement. The candidate may also supportrelated programs that mayimpactFederal Health InsuranceMarketplace eligibility—such as Medicare, Medicaid, CHIP— as well asprovideprogram managementfor the audit team. As such, the candidate in this role willbe exposed toprogramintegrity and auditing research, technical writing, and will obtain diverse experience working with many differentstakeholders such asSerco Leadership; Service Delivery, IT,andOperations; and CMS Executives and subject matter experts.
The candidate(s) in this position ideally brings unique combination of subject matterexpertiseinfederal health policy and programcompliance, particularlythe FederalHealth Insurance Marketplace, including technical understanding of eligibility and enrollment processes to coordinate andoptimizemultiple aspects of verification and program integrity operations.
As a Federal Health Insurance Marketplace Program Auditor, you will:
Serve ascompliancesubject matter expertfor internal and externalprogramaudits and processes.This includes:
Conduct complex detailed analyses of theprogram’s internal operations and business processes to assessrisk management practices, internal control design, and compliance with laws, rules, policies/procedures, contract terms / conditions or regulatory requirements.
Develop audit findings and recommendations to improve operations anddeliverto client inhigh-quality written reports.
Present audit results to managementand clientat quarterly review meetingswith clear andconcise descriptionson compliance issues including findings,recommendations orrequirements, and potential impact.
Support client in external audits by extracting, reviewing,analyzingand responding to auditors and on selected cases reviewedusing a policy and operations lens.
Identifyproblems and barriers that may arise during the audit process and involveappropriate partiesas necessary to resolve the issues.
Track and report actions taken in response to audit recommendations.
Provide project management by tracking program audit activities paying close attention to deadlines, consistent documentation, and high-quality deliverables.
Deliver high-level, strategic written and oral briefings to ES and Serco Leadership
Collaboratively with CMS and Serco teams, produce high-level, well-written memos, briefs, analysis, evaluations,reportsand presentations.
Develop andmaintaineffective and efficient working relationships with the Client, interfacing with government SMEs and Serco teams.
Performs other tasks asrequiredor assigned.
Qualifications
To be successful in this role, you must have:
Bachelor’s degree inbusiness administration,public health, health administration, or otherappropriate advanceddegree.
Minimum five years’ experienceprovidingFederal Health InsuranceMarketplacepolicyexpertisein government or advocacy organization
Minimum five years of experience performingcomplexprogram auditsincluding data gathering, analysis, and verifying evidenceontheFederal Health Insurance Marketplaceprogram
Preferred, three years of project management experience.
Additional desired qualifications include:
Understanding and experience in program integrity or auditingFederal Health Insurance Marketplaceprogram.
Extensive knowledge of the techniques and methods used in program compliance.
High-level expertise in Affordable Care Act legislative, regulatory and sub-regulatory guidance.
Well-versed on the Federal Health Insurance Marketplace's eligibility and enrollment processes and the operations that support verifications.
Knowledge of other federal healthcareprograms (such as Medicaid, Children’s Health Insurance Program and Medicare) and private health insurance industry.
Good judgment, a well-developed sense of propriety, political acumen, and the ability to think constructively.
Ability to deal with complex and changing policy and political environment.
Strong leadership and organizational skills.
Exceptional interpersonal and client management skills.
Excellent verbal and written communications skills.
Enjoy working infast-paced and collaborative team environment.
This position can be hybrid or full-time remote work.
If you are interested in makingandimpact and working with a passionate team - thensubmityour application now for immediate consideration. It only takes a few minutes and could change your career!
Company Overview
Serco Inc. (Serco) is the Americas division of Serco Group, plc. In North America, Serco’s 9,000+ employees strive to make an impact every day across 100+ sites in the areas of Defense, Citizen Services, and Transportation. We help our clients deliver vital services more efficiently while increasing the satisfaction of their end customers. Serco serves every branch of the U.S. military, numerous U.S. Federal civilian agencies, the Intelligence Community, the Canadian government, state, provincial and local governments, and commercial clients. While your place may look a little different depending on your role, we know you will find yours here. Wherever you work and whatever you do, we invite you to discover your place in our world. Serco is a place you can count on and where you can make an impact because every contribution matters.
To review Serco benefits please visit: https://www.serco.com/na/careers/benefits-of-choosing-serco . If you require an accommodation with the application process please email: careers@serco-na.com or call the HR Service Desk at 800-628-6458, option 1. Please note, due to EEOC/OFCCP compliance, Serco is unable to accept resumes by email.
Candidates may be asked to present proof of identify during the selection process. If requested, this will require presentation of a government-issued I.D. (with photo) with name and address that match the information entered on the application. Serco will not take possession of or retain/store the information provided as proof of identity. For more information on how Serco uses your information, please see ourApplicant Privacy Policy and Notice (https://www.serco.com/na/privacy-policy) .
Serco does not accept unsolicited resumes through or from search firms or staffing agencies without being a contracted approved vendor. All unsolicited resumes will be considered the property of Serco and will not be obligated to pay a placement or contract fee. If you are interested in becoming an approved vendor at Serco, please email Agencies@serco-na.com .
Serco is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.
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ID 64124
Recruiting Location : Location US-VA-
Category Other
Position Type Full-Time
Security Clearance None
Telework Yes - May Consider Full Time Teleworking for this position