Senior Healthcare Model SME (CMS)

Overview

CVP is seeking a Senior Healthcare Model Subject Matter Expert (SME) to provide strategic, high-level advisory leadership supporting the Center for Medicare and Medicaid Innovation (CMMI) and related CMS contracts. This role serves as a senior technical authority on healthcare payment and service delivery models, advising on model design, implementation, and evaluation across complex, high-visibility CMMI efforts.

 

The Senior SME will partner directly with CMS and CMMI leadership, translating policy objectives into executable model and evaluation frameworks. While the primary focus is CMMI, we value expertise gained across other CMS divisions (e.g., CMCS, CCIIO, CCSQ) where candidates demonstrate strong understanding of CMS policy development and implementation lifecycles.

 

This role operates with a high degree of autonomy and is intended for a seasoned professional who can guide strategy, ensure methodological rigor, and provide trusted counsel in a dynamic federal policy environment.

Responsibilities

• Serve as the principal subject matter expert for CMS healthcare models, providing strategic advisory support on model design, participant alignment, payment mechanisms, implementation approaches, and quality measurement strategies.
• Translate CMS policy objectives into clear, executable model and evaluation frameworks, partnering with internal teams and CMS/CMMI stakeholders.
• Provide senior oversight for evaluations, implementation and monitoring and learning systems, ensuring approaches are rigorous, policy-relevant, and decision-focused. 
• Interface directly with CMS/CMMI leadership and stakeholders to interpret policy requirements, present findings, and advise on model refinements and operational adjustments.
• Serve as a senior technical reviewer for key deliverables, including reports, white papers, and policy recommendations, ensuring accuracy, clarity, and alignment with CMS standards and guidance.
• Guide cross-functional teams across policy, operations, analytics, and research to ensure datasets, monitoring, and analyses accurately reflect model logic and program intent.
• Support and, as needed, facilitate high-level meetings, technical discussions, and expert forums related to complex healthcare models and evaluations.
• Mentor and provide subject matter guidance to analysts and researchers, strengthening CMS fluency and building durable internal expertise across the portfolio.

Qualifications

• Minimum of 10 years of experience supporting CMS programs, with strong preference for direct experience with the Center for Medicare and Medicaid Innovation (CMMI).
• Demonstrated expertise in the design, implementation, monitoring, and evaluation of CMS payment and service delivery models.
• Deep familiarity with complex healthcare policy and regulatory frameworks, such as bundled payments, accountable care organizations (ACOs), kidney care models, or similar initiatives.
• Experience delivering on high-visibility CMS task orders, with working knowledge of CMS contracting vehicles such as RMADA.
• Strong understanding of Medicare and/or Medicaid claims data and CMS analytic environments (e.g., CCW, Model Space, or comparable secure CMS data platforms).
• Proven ability to communicate complex technical and policy concepts clearly and effectively to senior government stakeholders.
• Demonstrated ability to provide senior technical oversight and judgment across multidisciplinary teams.
• Ability to obtain and maintain a Public Trust clearance.

 Desired Skills

• Proven ability to set and direct technical and analytic strategy for complex healthcare models.
• Experience guiding teams providing policy-related guidance to teams who support implementation, monitoring, and/or evaluation of complex healthcare models.
• Strong facilitation skills for high-level meetings, technical discussions, and expert forums, including engagement with senior government stakeholders.
• Ability to synthesize complex qualitative and quantitative findings into clear, actionable guidance for policy and program leadership.
• Demonstrated judgment in navigating ambiguity, evolving policy requirements, and competing stakeholder priorities.
• Experience coordinating across policy, operations, analytics, and delivery teams to maintain alignment and momentum across multiple workstreams.
• Strong written and verbal communication skills, with the ability to review and shape executive-level deliverables for clarity and impact.
• Familiarity with federal acquisition and delivery environments, including collaboration across multiple contractors and government teams.

 

About CVP

 

CVP is an award-winning healt