Medical Advisor

Summary This is a permanent position in the Civil Fraud Section, which pursues health care fraud cases under the False Claims Act. These positions will support a significant expansion of the data, research, and analytics team in the Fraud Section. They require clinical, public health, and coding expertise to advise the data team and attorneys of the most likely potential fraud areas based on observable data patterns in light of the incumbent's medical expertise. Learn more about this agency Requirements Conditions of Employment You must be a United States Citizen or National. You will be required to complete a pre-employment security investigation and background check which includes a drug screening. You may be required to complete a one-year probationary period. Selective Service registration is required for males born on, or after, December 31st 1959. Those not registered should have an approved exemption on file. You must meet all eligibility requirements by the closing date of this announcement and continue to meet these requirements throughout the hiring process. Offers can be rescinded if requirements are not met. Qualifications To qualify for the position of Medical Advisor, (GS-0601-15), you must meet the basic qualification requirements listed below AND possess the required specialized experience specific to the series and grade you are applying to. Candidates must possess the following basic requirements to receive consideration for this position:1) A Bachelor's or graduate/higher level degree: major study in an academic field related to the medical field, health sciences or allied sciences appropriate to the work of the position. In addition to the Basic Requirements, you must also meet the Minimum Qualifications stated below. To qualify for the GS-15 position, you must have at least one full year of specialized experience equivalent to the GS-14 level in the Federal service assisting in health care fraud prevention, detection, and enforcement by providing advisement on relevant medicine, coding, public health, and health care financing programs. Conducting coding assessment and/or reviews of clinical procedures. Conducting assessment, research, or advisement on Medicare coverage requirements. Advising on Medicare policies and/or whether certain items or services are rendered consistent with those requirements/policies. Providing medical guidance and technical support in conceiving and conducting health care fraud investigations and enforcement actions. Analyzing medical, clinical, or health care claims data. Conducting medical, clinical, or coding research to provide advice to investigative teams conduct reviews of medical records and presents the findings. You MUST meet all qualification requirements by the closing date of this announcement, 12/10/2024. Your resume must support your responses to the questionnaire and qualification requirements. Failure to do so may result in an ineligible rating. See the Required Documents section for important notes about what must be included in your resume. Education This position has a basic education requirement consisting of a Bachelor's or graduate/higher level degree in a major academic field or study related to the medical field, health sciences or allied sciences appropriate to the work of the position. Education must be reviewed and certified by an accrediting institution recognized by the U.S. Department of Education in order for it to be creditable toward your qualifications. Therefore, you should provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education. Foreign Education: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show that the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university.For more information about this requirement, please visit the U.S. Department of Education website for Foreign Education Evaluation. All documentation must be in English or include an English translation. Additional information CAREER TRANSITION PROGRAMS (CTAP or ICTAP): For more information visit: USAJOBS Career Transition Programs VETERANS AND MILITARY SPOUSES: Please see USAJOBS Veterans Preference for more details. REASONABLE ACCOMMODATION: Our policy can be found at: https://www.justice.gov/jmd/reasonable-accommodation#policy DOJ EEO STATEMENT: The U.S. Department of Justice fosters an inclusive and diverse workforce, find our EEO statement online at: https://www.justice.gov/jmd/page/file/1394116/download SELECTIVE SERVICE: If you were born male, on or after December 31, 1959, you must certify that you have registered with the Selective Service System, or are exempt from having to do so under the Selective Service Law. Additional information is found at: www.sss.gov. Read more Benefits A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new window Learn more about federal benefits. Review our benefits Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.