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Medicare Provider Enrollment SME

Remote/Hybrid if local to Maryland

Join us at Sparksoft, where we're not just another tech company—we're a catalyst for change. Our mission isn't just to offer IT solutions; it's to revolutionize the way you work. Here, passion isn't just a buzzword; it's the fuel behind groundbreaking ideas and transformative technologies. We serve a wide range of government clients, delivering impact that's felt across the nation.

Our true strength lies in our people. They're the problem-solvers and innovators consistently delivering extraordinary outcomes. With Sparksoft, you're not stepping into a routine job; you're joining a team committed to innovation and excellence. Our innovation extends beyond just delivering projects. Through our specialized Innovation Centers, we continuously refine our methods, ensuring we remain industry leaders.

We are Sparksoft!

ROLE & RESPONSIBILITIES: 

The Medicare Provider Enrollment SME acts as a government healthcare business adviser to both the customer and the project team in all phases of the project. They will work collaboratively with the product manager, product owners, business owners, and the data and reporting services teams to deliver business value in support of the Centers for Medicare & Medicaid Services (CMS) in detecting and preventing fraud, waste, and abuse within government-sponsored health programs.

•    Serve as a liaison and trusted partner to CMS business and system owners and key stakeholders including other CMS systems groups and data vendors
•    Apply extensive federal healthcare program knowledge to provide analysis, solutions and requirements for teams across all areas of the APS project
•    Facilitate and participate in client-facing meetings with multiple levels of CMS leadership and end user groups, including requirement gathering sessions, project meetings, and training initiatives.
•    Work with Product Team to engage system and business owners to gather business requirements and translated them to ensure alignment with development and QA teams leveraging subject matter expertise in federal healthcare programs
•    Focus on achieving efficiencies through automation, modeling, best practices and procedures. 
•    Seek out and apply relationships, tasks and resources for each process and insert those solutions into the development lifecycle. 
•    Possess a working knowledge of regulations related to Medicare, Medicaid and other Federal Healthcare Programs and be capable of applying that knowledgebase to entities affiliated with these programs. 

REQUIRED EXPERIENCE:

  • 7+ years of relevant experience
  •  Experience in the evaluation, assessment, and administration of Federal Healthcare Programs focused on Medicare and Medicaid
  • Comprehensive knowledge of the HHS Code of Federal Regulations, the Medicare Program Integrity Manual and will serve as an authority in Medicare and Medicaid business knowledge on the project.
  •  Demonstrate exceptional oral and written communication skills.
  • Strong analytical mind with problem-solving aptitude.
  • Ability to effectively transfer knowledge to other team members.
  • Ability to work in a fast-paced, deadline-driven environment. 
  • Ensure customer satisfaction through follow-up, client responsiveness, and thorough communication
  • Ability to manage multiple clients and projects/tasks simultaneously.
  • Candidates must be able to obtain and maintain a Public Trust clearance
  • Candidates must have lived in the United States 3 out of the past 5 years

PREFERRED EXPERIENCE: 

  • Possess knowledge of Agile methodology (such as Scrum) and/or Scaled Agile Framework (SAFe).
  • SAFe Agile Certification (preferred).
  • Understanding of the CMS Targeted Lifecycle (TLC)

EDUCATION & CERTIFICATIONS:

  • Associate's degree (or higher) Required 

 

Accessibility and Accommodations: Sparksoft Corporation is committed to providing equal employment opportunities to all individuals. If you require accommodations during the application or interview process, please contact us at Sparksoft.Accommodations@sparksoftcorp.com or call 410-424-7700. Requests are reviewed and fulfilled on a case-by-case basis.

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Artificial intelligence (AI) Policy: While Sparksoft recognizes the value of artificial intelligence in the workplace, our hiring process is designed to assess each candidate’s individual skills, judgment, and problem-solving abilities. To maintain the integrity of this process, the use of AI tools at any stage of the application or interview is strictly prohibited. Violations of this policy may result in disqualification from consideration.

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