Notice ID: CMS-A240106
Description
The Centers for Medicare & Medicaid Services (CMS) is a federal agency that ensures health care coverage for more than 100 million Americans through Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace. As the single largest payer for health care in the United States, CMS generates and collects enormous amounts of data. CMS recognizes that ensuring access to its data is key to driving innovation and promoting high-value, person-centered care.
Required Knowledge and Experience
At a minimum, the following knowledge and experience with the U.S. Department of Health and Human Services (HHS)/CMS or equivalent is required:
- Proficiency with Medicare Parts A, B, and D, administrative, claims, assessment, and/ or financial data in the CMS environment or similar health insurance environment;
- Proficiency with Medicare Advantage encounter data;
- Proficiency with Medicaid claims data;
- Proficiency with CMS enrollment data;
- Proficiency with Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) and proficiency in understanding of Medicare Part B payment systems (e.g., Outpatient billing and Physician and Other Practitioner fee schedules);
- Proficiency working with and safeguarding PHI and PII;
- Proficiency providing all stages of data analytics (data acquisition, validation, analysis, algorithms, adjusting for outliers, etc.) under tight timeframes;
- Proficiency researching, reviewing, and interpreting CMS policy (e.g., Final Rule for Medicare Skilled Nursing Facilities) and applying this knowledge to the data that is analyzed;
- Proficiency in conducting and applying suppression to deliverables;
