Auditor (Medicare Part C)

Applicants must meet all the qualification requirements, including education, and any selective placement factors described below within 30 days of the closing date of this announcement. Education used as part of an application package will only be considered if complete transcripts are submitted and must be from an accredited institution as recognized by the U.S. Department of Education.

To see if your institution is accredited, please follow this link: Database of Accredited Postsecondary Institutions and Programs. Positive Education Requirement: This position has a position education requirement, as indicated below. A complete transcript showing relevant coursework and degrees must be submitted with your application package. A list of completed courses or incomplete transcripts will not be accepted.

Individual Occupational Requirements: Applicants must have a bachelor's degree in accounting; or a degree in a related field such as business administration, finance, or public administration that included or was supplemented by 24 semester hours in accounting. The 24 hours may include up to 6 hours of credit in business law.

OR Applicants must have a combination of education and experience at least 4 years of experience in accounting; or an equivalent combination of accounting experience, college-level education, and training that provided professional accounting knowledge. The applicant's background must also include one of the following: Twenty-four semester hours in accounting or auditing courses of appropriate type and quality.

This can include up to 6 hours of business law; A certificate as a Certified Public Accountant or a Certified Internal Auditor, obtained through written examination; or Completion of the requirements for a degree that included substantial course work in accounting or auditing, e.g.

15 semester hours, but that does not fully satisfy the 24 semester-hour requirement listed above, provided that: (a) the applicant has successfully worked at the full performance level in accounting, auditing, or a related field, e.g. valuation engineering or financial institution examining; (b) a panel of at least two higher level professional accountants or auditors has determined that the applicant has demonstrated a good knowledge of accounting and of related and underlying fields that equals in breadth, depth, currency, and level of advancement that which is normally associated with successful completion of the 4-year course of study described above; and (c) except for literal nonconformance to the requirement of 24 semester hours in accounting, the applicant's education, training and experience fully meet the specified requirements.

Specialized Experience: In addition to meeting the individual occupational requirements above, applicants must have 1 year of specialized experience equivalent to the GS-12 grade level in the Federal service which provided the applicant with the knowledge, skills and abilities to perform the duties of the position.

Qualifying specialized experience must demonstrate experience: Assisting in planning and conducting audits of Medicare and/or Medicaid programs; Providing technical guidance to team members throughout the audit process; and Participating in drafting engagement committee proposals, job design documents, audit debrief documents and/or audit reports.

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community, student, social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.

Your resume should include the dates of all qualifying experience (from month/year to month/year) and the number of hours worked/volunteered per week. Federal experience is not required. The experience may have been gained in the public sector, private sector or Volunteer Service. One year of experience refers to full-time work; part-timework is considered on a prorated basis.

To ensure full credit for your work experience, please indicate dates of employment by month/year, and indicate number of hours worked per week, on your resume.

This position is established as a senior auditor in a division office (Centers for Medicare and Medicaid Audit Division (CMSAD), Office of Audit Services (OAS), Office of the Inspector General (OIG), Health and Human Services (HHS). The senior auditor will provide audit services to CMSAD which conducts and oversees audits of the Medicare and Medicaid programs.

The senior auditor in CMSAD serves as a subject matter expert for Medicare, Medicaid, and Children's Health Insurance programs which are extremely large (approximately $1.5 trillion in annual spending) Federal healthcare programs with very complex rules and regulations. The senior auditor assists in directing CMSAD audits that focus on applicable OIG priority outcomes.

The senior auditor receives assignments to serve as a member of an audit team and independent work assignments for an audit segment or study project. The incumbent studies pertinent laws, legislative history, regulations, contracts, and management controls to ascertain the purpose, scope, and objectives of the organization or function; the manner in which the organization or function is conducted and financed; and the nature and extent of management authority and responsibility for the organization or function.

Plans and contributes to comprehensive audits for a wide range of health and human services programs, grantees and contractors, and others receiving funds from programs administered by the Department. Develops or modifies auditing methods and techniques to resolve a variety of complex auditing problems. Conducts detailed presurvey analysis, including correlation of findings and conclusions resulting from pre-survey analysis and evaluation to ascertain probable scope and depth of audit and to identify problems.

Provides advance notification and develops and disseminates guidelines on probable areas of emphasis, approaches which may be expected, pre-survey readiness actions, development of audit response plan. The senior auditor will provide expert advice and direction for the program content of medical review contracts. The senior auditor will coordinate with the Division Director and regional staff to ensure that medical review is performed when needed.

The senior auditor will assist in the monitoring of the contractors' adherence to program requirements and interact, if necessary, report any deficiencies to the Division Director.