Plan Program Integrity Medicare Drug Integrity Contractor (PPI MEDIC)

The Centers for Medicare & Medicaid Services (CMS) is seeking a contractor to provide oversight of the Medicare Parts C and D programs. The contractor will be responsible for tasks such as data analysis, audits, and reviews of Medicare Advantage Organizations (MAOs) and Prescription Drug Plan (PDP) sponsors. The contractor will also be involved in outreach, education, and referrals to law enforcement. The scope of work includes providing support for CMS audits and program integrity oversight activities related to fraud, waste, and abuse efforts within the Medicare Parts C and D programs. Some key aspects of the job include: • Data analysis and audits of MAOs and PDP sponsors • Reviews of MAOs and PDP sponsors to ensure compliance with regulations • Outreach, education, and referrals to law enforcement • Support for CMS audits and program integrity oversight activities • Ongoing work with the Medicare Parts C and D programs