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Job Details

Business Operations Specialist ( R-00090886 )


Security Operations



Baltimore, Maryland, United States


Job Description:

Leidos delivers innovative IT solutions and services to the Centers for Medicare & Medicaid Services (CMS) and other Federal Health agencies. Leidos is currently seeking Business Operations Specialist to join our portfolio of Fraud, Waste and Abuse programs. In this operational role, you will leverage your knowledge of Fraud Waste and Abuse techniques in a Medicare/Medicaid environment to oversee and manage complex systems, workflows and projects.

Primary Responsibilities

  • Lead and support user services teams such as coaching, outreach and helpdesk in meeting established program goals and objectives.
  • Manage all technical, personnel, expenditures and process improvement aspects for identifying and implementing Fraud, Waste and Abuse (FWA) data, tool and analytic synergies within the Medicare program that focus on cost savings and workflow efficiencies.
  • Liaison with program contractors, partners and stakeholders to ensure successful communication and collaboration. Establish strategic relationships with key partners to influence performance efficiency and effectiveness.
  • Champion the needs of the users and provide recommendations for improving the system capabilities and performance to enhance the value for end users.
  • Manage One PI resource utilization monitoring process that assists end users in generating efficient queries and or reports in accessing Medicare claims information against the Integrated Data Repository.(IDR)
  • Manage One PI Learning Management System (LMS) which assists users in training activities for SAS and Business Objects data analytic tools to access the Integrated Data Repository (IDR) in performing Medicare Fraud, Waste and Abuse activities.

Basic Qualifications

  • BA/BS Degree
  • 12+ years’ experience w/Medicare Programs and Contracts
  • Experience managing complex systems and workflow and complex projects with tight deadlines.
  • Experience with One PI Learning Management System
  • Knowledge of how to fight Fraud, Waste and Abuse in Medicare and/or Medicaid.
  • Knowledge of Medicare reimbursement principles as they apply to Medicare Part A, B, D, and Medicare Advantage.

Preferred Qualifications

  • Proficient in Vendor Invoice Processing (VIP) and Medicare Card (MCS) claims processing systems
  • Experience with One PI Learning Management System.
  • Knowledgeable in Business Objects (DESKI and WEBI versions) and DataProbe,
  • Experience with the following systems: STARSInformant, HCFA Customer Information Systems (HCIS) and Fraud Investigation Data Base (FID)
  • Proficient in Microsoft Office (Excel, Access, Visio and Project applications).

Pay Range:Pay Range $101,400.00 - $156,000.00 - $210,600.00

The Leidos pay range for this job level is a general guideline only and not a guarantee of compensation or salary. Additional factors considered in extending an offer include (but are not limited to) responsibilities of the job, education, experience, knowledge, skills, and abilities, as well as internal equity, alignment with market data, applicable bargaining agreement (if any), or other law.