Provider Enrollment Site Visit Analyst

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Program Integrity, Provider Enrollment & Oversight Group (PEOG). As a Provider Enrollment Site Visit Analyst, GS-0107-9/11, the incumbent carries out compliance reviews of Medicare providers and suppliers by visiting their physical locations/worksites. This helps ensure program integrity and safeguards Medicare beneficiaries and taxpayer resources.

Reviews financial payments and provider enrollment to identify fraud, waste, and abuse. Applies established methods to analyze allegations, uses protocols to assess operational issues, and conducts studies to address program vulnerabilities.

Develops and interprets policies and regulations for program integrity. Identifies policy issues, recommends solutions, formulates conclusions that inform management decisions, and conducts studies to improve sanctions and integrity initiatives.

Collaborates with CMS, state agencies, contractors, and providers, as well as external agencies like HHS OIG, FBI, and DOJ on FWA matters. Compiles case summaries and engages with officials across the health care sector.

Communicates findings through briefings and reports, represents the agency at meetings, provides technical advice on program vulnerabilities, and responds to inquiries about provider enrollment and integrity issues