Federal Healthcare Program Subject Matter Expert (SME)

Who We Are:

Tria Federal delivers digital services and technology solutions that support the health and safety of veterans, service members and civilians. For two decades, federal agencies have relied on Tria companies to advance their critical missions and modernize their systems, so that they can uphold their commitment to the American people. Today, we are pushing the boundaries of possibility through partnerships and investments in artificial intelligence and emerging technologies, developing solutions for the biggest challenges that will face government tomorrow.

Job Description: (Contingent Upon Award)

The SME will act as a government healthcare business advisor and liaison to the Government and contracted staff. The SME should analyze processes, propose functional business solutions, and define IT system/application requirements for Medicare, Medicaid, and other Federal Healthcare Programs. The SME shall be focused on achieving efficiencies through automation, modeling, best practices, and procedures. The SME shall seek out and apply relationships, tasks, and resources for each process and insert those solutions into the development lifecycle.

Basic Requirements:

• Ability to obtain a U.S. Federal Position of Trust clearance designation.
• Must reside in and be able to perform work in the United States.
• Must have lived in the United States for 3 of the last 5 years.
• Bachelor's Degree or higher
• 5+ years serving as an authority in Medicare and Medicaid business knowledge.
• 5+ experience applying working knowledge of regulations and workflows and experience in the evaluation, assessment, and administration of Federal Healthcare Programs, specifically Medicare and Medicaid.
• Comprehensive knowledge of the HHS Code of Federal Regulations and the Medicare Program Integrity Manual (PIM).
• Exceptional oral and written communication skills.
• Superior communication and organization skills are a must with ability to handle multiple tasks in a fast-paced work environment and thrive in an environment with regularly changing priorities.
• Prior experience as a business analyst, SME, and/or product manager/analyst on federal healthcare programs desired.
• Prior experience in federal healthcare program integrity desired.

Responsibilities:

• Acts as a government healthcare business advisor and liaison to the Government and contracted staff.
• Serves as an authority in Medicare and Medicaid business knowledge, especially as it pertains to program integrity.
• Applies knowledge of the HHS Code of Federal Regulations and the Medicare Program Integrity Manual (PIM) to define user needs, business processes, and application workflows.
• Evaluates and assesses Medicare and Medicaid program policy and administration to develop business requirements.
• Analyzes processes, proposes functional business solutions, and defines IT system/application requirements based on knowledge of Medicare, Medicaid, and other Federal Healthcare Programs.
• Contributes to achieving efficiencies through automation, modeling, best practices, and procedures.
• Seeks out and apply relationships, tasks, and resources for each process and inserts those solutions into the application development lifecycle.
• Identifies and recommends policy, procedure, and system changes to enhance project outcomes and performance.
• Identifies areas for improvement and makes recommendations to increase the quality and effectiveness based on best practices.
• Maintains positive, productive relationships with colleagues, managers, partners, customer, and users to foster collaboration and consensus.

Public Trust Clearance: This role will require the hired candidate to go through public trust clearance. A minimum of 3 years of stay in the U.S. within the last 5 years is required to be eligible to qualify for public trust clearance sponsorship.

Work Location: Headquartered in Arlington, VA, we also have a primary office in Baltimore, MD for those who prefer to work on-site. However, with employees spread across 40+ states, we have many remote roles.

Why Tria?
What defines the Tria brand is more than just our dedication to excellence in our craft; it's our incredible team of dedicated, talented, and passionate people that make Tria so exceptional. As people powering possible, we are all partners in our team's shared success.

As a company that cares about people, we seek to cultivate a culture in which all can thrive personally and professionally. We offer a top-tier benefits package to invest in your physical, mental, and financial health and wellness so that you can be your best self - at work and in life. At Tria, we are growth-minded, entrepreneurial in spirit, and committed to fostering a culture of inclusion and opportunity for all. Whatever your background, your role, your department, or stage in your professional journey, here you will have opportunities to learn new skills, seize new challenges, and advance your career as we grow.

California Consumer Privacy Act (CCPA)

We are committed to protecting your privacy. As part of our compliance with the California Consumer Privacy Act (CCPA), we want to inform you about how we collect, use, and protect your personal information during the job application process. For more details, please review https://www.oag.ca.gov/privacy/ccpa .

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