Analyze and support Medicare claims processing within the Common Working File (CWF), identifying trends, root causes, and opportunities for system and process improvement.
Serve as a liaison between CMS, MAC stakeholders, and technical teams to investigate issues, clarify requirements, and support resolution of production incidents.
Evaluate and resolve complex data and system issues, including performing data corrections using CWF HICR transactions, ensuring accuracy and compliance with Medicare policies.
Participate in CMS change request early involvement calls, providing operational insights, impact analysis, and feedback on proposed system enhancements.
Conduct root cause analysis on production issues and recommend solutions to improve system performance and business outcomes.
Support ticket triage and lifecycle management, ensuring clear documentation, impact assessment, and communication with stakeholders.
Generate and analyze CMS monthly reporting metrics to identify patterns, risks, and opportunities for operational improvement.
Collaborate with cross-functional teams to support ongoing system enhancements, production stability, and business process alignment.
Support 24×7 production processing cycles and special processing needs for release related utilities as needed.
Requirements
Bachelor’s degree and 4+ years of Medicare experience (or equivalent combination of education/experience may be considered).
Hands on experience supporting mainframe operations and federal health claims processing.
Strong proficiency with TSO/ISPF, IBM utilities, and enterprise scheduling tools (TWS, TDWC).
Familiarity with incident/ticket management tools and workflow processes.
Excellent written and verbal communication skills, including ability to coordinate across technical and non-technical teams.
Detail oriented, organized, and capable of managing multiple concurrent tasks in a fast-paced production environment.
Ability to obtain and maintain a CMS Public Trust clearance.
Additional Experience Required: TSO/ISPF/JCL Service Now Microsoft Office Suite.
Preferred Qualifications: Experience working with CMS (Center for Medicare/Medicaid Services). Jira / Confluence / ALM Micro-Focus Certified Scrum Master (CSM). Certified Scrum Product Owner (CSPO). Experience in z/OS, z/VM, z/Linux, or UNIX environments.
Tech Stack
Linux
Unix
Benefits
Paid Time Off (PTO) accrued based on Leidos policy, up to 3 weeks a year.
Eleven (11) paid holidays per year.
Access to benefits on day one including medical and dental insurance, 401K, Life, AD&D, Voluntary Disability plans.
Ongoing training to support your success.
Tuition reimbursement based on Leidos policy.
Discounted Leidos stock purchase and other Employee Discounts.