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Cms Government Jobs (NOW HIRING)

Cotiviti

Business knowledge of and network of relationships with the VA, DHA, CMS, and/or State Government agencies required. * Business knowledge of and network of relationships with the VA, DHA, CMS and/or ...

SBC Innovations LLC

Sr. CMS Drupal Developer

May require occasional after-hours deployment support The Senior CMS Drupal Developer is ... Experience supporting federal government web applications * Familiarity with NIST cybersecurity ...

Berger Singerman

NY · On-site

Experience working with Medicare, CMS, government enforcement agencies, or with payers or managed care organizations is a plus. Core requirements include strong healthcare regulatory and ...

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How much do cms government jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for cms government in the United States is $53.66, according to ZipRecruiter salary data. Most workers in this role earn between $41.11 and $53.85 per hour, depending on experience, location, and employer.

Is CMS a good career path?

A career as a CMS (Content Management System) specialist or administrator involves managing digital content, often requiring skills in web development, content editing, and system maintenance. It can be a stable and growing field with opportunities in various industries, especially for those with technical skills and certifications in platforms like WordPress, Drupal, or Joomla.

What skills and qualifications are needed to thrive as a CMS Government Program Analyst?

To thrive as a CMS Government Program Analyst, you need expertise in public health policy, data analysis, and program management, typically backed by a relevant degree in public administration, health policy, or a related field. Familiarity with tools such as SAS, SPSS, Microsoft Excel, and knowledge of CMS regulations and reporting systems is essential. Strong analytical thinking, communication, and project management skills help you collaborate effectively and present complex information clearly. These skills are vital to ensure programs comply with federal regulations, improve healthcare outcomes, and manage large-scale government initiatives efficiently.

What is a CMS Government job?

CMS Government jobs refer to positions within the Centers for Medicare & Medicaid Services (CMS), a federal agency under the U.S. Department of Health and Human Services. Employees in these roles work on developing, implementing, and managing national healthcare programs such as Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). CMS Government jobs encompass a wide range of professions, including policy analysis, healthcare administration, IT, and public health. These positions aim to improve healthcare access, quality, and affordability for millions of Americans.

What is the difference between Cms Government vs Cms Healthcare?

AspectCms GovernmentCms Healthcare
CredentialsTypically requires knowledge of government policies, certifications in public administration or government-related fieldsRequires healthcare industry certifications, such as medical coding or healthcare administration
Work EnvironmentPrimarily in government offices, public sector settingsIn healthcare facilities, clinics, or hospitals
Employer & IndustryGovernment agencies, public sector organizationsHealthcare providers, hospitals, clinics
Search & Comparison IntentPeople comparing government-related roles in healthcare administrationIndividuals interested in healthcare-specific CMS roles

In summary, Cms Government focuses on roles within government agencies managing healthcare policies, while Cms Healthcare pertains to healthcare-specific CMS roles in medical settings. Both require relevant certifications but differ mainly in work environment and employer type.

What are common challenges faced when working in a CMS Government role, and how can applicants prepare for them?

Professionals in CMS government roles often navigate complex regulatory requirements and work with diverse stakeholders such as healthcare providers, contractors, and state agencies. A common challenge is staying updated on frequently evolving policies and ensuring compliance across all projects. Applicants can prepare by familiarizing themselves with relevant federal programs, developing strong communication skills, and cultivating adaptability to handle policy changes efficiently. Collaborative teamwork and attention to detail are also essential, as these roles often require coordination across multiple departments and adherence to strict deadlines.
More about Cms Government jobs
What cities are hiring for Cms Government jobs? Cities with the most Cms Government job openings:
What states have the most Cms Government jobs? States with the most job openings for Cms Government jobs include:
What job categories do people searching Cms Government jobs look for? The top searched job categories for Cms Government jobs are:
Cms Government jobs near you
Infographic showing various Cms Government job openings in the United States as of August 2026, with employment types broken down into 90% Full Time, 7% Part Time, and 3% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $111,611 per year, or $53.7 per hour.

Medical Review Nurse - CMS/RAC Auditor, Government Audits

Machinify

Remote

Full-time

Re-posted 12 days ago

Job description

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We're constantly reimagining what's possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.
The Medical Review Nurse - CMS / RAC (Government Audits) primarily performs medical claims audit reviews for government clients. As a MR Nurse, you will join a team of experienced medical auditors and coders performing retrospective and prepayment audits on claims for Government Payers. You will work remotely in a fast paced and dynamic environment and be part of a multi-location team.
Please note: RAC certification is preferred for this role. The selected candidate may need to work toward RAC certification if they do not currently have it.
Key Responsibilities:
  • Auditing claims for medically appropriate services provided in both inpatient and outpatient settings while applying appropriate medical review guidelines, policies and rules.
  • Document all findings referencing the appropriate policies and rules.
  • Generate letters articulating audit findings.
  • Supporting your findings during the appeals process if requested.
  • Working collaboratively with the audit team to identify and obtain approval for particular vulnerabilities and/or cases subject to potential abuse.
  • Work in partnership with our clients, CMD colleagues, and other contractors on improving medical policies, provider education, and system edits.
  • Keep abreast of medical practice, changes in technology, and regulatory issues that may affect our clients.
  • Work with the team to minimize the number of appeals; Suggest ideas that may improve audit workflows; Assist with QA functions and training team members.
  • Participate in establishing edit parameters, new issue packets and development of Medical Review Guidelines.
  • Interface with and support the Medical Director and cross train in all clinical departments/areas.
  • Other duties as required to meet business needs.

Knowledge, Skills and Abilities Needed:
  • Experience with utilization management systems or clinical decision-making tools such as Medical Coverage Guidelines (MCG) or InterQual.
  • Experience with and deep knowledge of ICD-9, ICD-10, CPT-4 or HCPCS coding.
  • Knowledge of insurance programs program, particularly the coverage and payment rules.
  • Ability to maintain high quality work while meeting strict deadlines.
  • Excellent written and verbal communication skills.
  • Ability to manage multiple tasks including desk audits and claims review.
  • Must be able to independently use standard office computer technology (e.g. email telephone, copier, etc.) and have experience using a case management system/tools to review and document findings.
  • Must be able to manage multiple assignments effectively, create documentation outlining findings and/or documenting suggestions, organize and prioritize workload
  • Effectively work independently and as a team, in a remote setting.

Required and Preferred Qualifications:
  • Active unrestricted RN license in good standing, is required.
  • Must not be currently sanctioned or excluded from the Medicare program by the OIG.
  • Minimum of five (5) years diversified nursing experience providing direct care in an inpatient or outpatient setting.
  • One (1) or more years' experience performing medical records review.
  • One (1) or more years' experience in health care claims that demonstrates expertise in, ICD-9/ICD-10 coding, HCPS/CPT coding, DRG and medical billing experience for an Insurance Company or hospital required.
  • Strong preference for experience performing utilization review for an insurance company, Tricare, MAC, or organizations performing similar functions.
  • RAC certification preferred.

Equal Employment Opportunity at Machinify
We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/

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