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Medical Advisor

US Offices, Boards and Divisions
Washington, DC

Apply Now

Job Details

Permanent | Part-time | Full-time
$169,279 - $197,200 a year

Qualifications

Health policy analysis
Healthcare financial misconduct investigations
Health data analysis
Medicare
Medicare coding guidelines
Presentations for conferences or internal meetings
Policy analysis
Investigative data analysis
Health insurance knowledge
Medicare regulations
Centers for Medicare and Medicaid Services (CMS)
Insurance investigations
Centers for Medicare & Medicaid Services (CMS) billing regulations
Medicaid regulations
Medicaid
Medical record review for legal cases
Research findings presentation
Healthcare coding investigations
Legal support investigation
Documentation reviews
Medical literature reviews

Full Job Description

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

This job is open to

The public

U.S. Citizens, Nationals or those who owe allegiance to the U.S.

Clarification from the agency

This position is being advertised under delegated examining procedures and is open to all U.S. Citizens. Preference for eligible veterans will be applied.

Duties

The duties and responsibilities for a GS-0601-15 Medical Advisor generally include, but are not limited to, the following:

Providing expert advice of relevant medicine, public health, and health care financing programs (with special emphasis on Medicare), coding, and methods to prevent and detect fraud and abuse.
Locating and reviewing medical literature and other medical and pharmacological information.
Reviewing information provided to Department staff on case matters by defendants and others to corroborate the accuracy of any medical content included.
Reviewing and analyzing medical records and presenting findings, either orally or in written reports.
Providing medical representation for the Department of Justice at meetings relevant to health care fraud, as requested by management.
Preparing oral and written presentations on medical and program policy issues as requested.
Providing guidance to Department attorneys and staff in connection with Medicare and Medicaid billing codes.
Recommending and proposing investigative steps or focus areas based upon review, from medical, clinical, or payor policy perspective, of health care data analysis.
Preparing written recommendations and proposals with detailed rationale drawing on review of data analysis conducted by Civil Division, and distilling medical, clinical, and payor policy expertise into proposals.

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. See “Additional Information” section for further details.
Selective Service registration is required for males born on, or after, December 31st 1959. Those not registered should have an approved exemption on file.
Financial Disclosure: If selected, you may be required to disclose financial information in accordance with DOJ and Federal ethics guidelines.

Qualifications

To qualify for the position of Medical Advisor, at GS-0601-15, you must meet the qualification requirements listed below.

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 close of this announcement.

Your resume must support your responses to the online questionnaire and the qualification requirements. Failure to do so may result in an ineligible rating.

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.

If you are relying on your education to meet qualification requirements, please see the statements below.

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 towards your qualifications. Therefore, provide only the attendance and/or degrees from accredited institution.

FOREIGN EDUCATION: Education completed in foreign colleges or universities may be used to meet the requirements. You must show proof the education credentials have been deemed to be at least equivalent to that gained in a conventional U.S. education program. It is your responsibility to provide such evidence when applying. For special instructions pertaining to foreign education and a list of organizations that can evaluate foreign education, see the Department of Education website. If you are qualifying on foreign education, you MUST submit proof of creditability of education as evaluated by a credentialing agency. Transcripts must be uploaded with your application to verify education. All documentation must be in English or include an English translation.

Additional information

Additional selections may be made from this announcement.

Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution. Candidates will not be hired based on their race, sex, color, religion, or national origin.

Career Transition Programs (CTAP or ICTAP):
These programs apply to Federal and/or DOJ employees who meet the definition of surplus or displaced from a position in the competitive service. To receive selection priority for this position, you must:

Meet CTAP or ICTAP eligibility criteria;

Be rated well-qualified for the position [with a score of 85] based on the competencies listed above; and

Submit the appropriate documentation to support your CTAP or ICTAP eligibility.

Probationary Period: As a condition of employment for accepting this position, you may be required to serve a 1-year As a condition of employment for accepting this position, you may be required to serve a 1-year probationary period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider:
1) your performance and conduct;
2) the needs and interests of the agency;
3) whether your continued employment would advance organizational goals of the agency or the Government; and
4) whether your continued employment would advance the efficiency of the Federal service.

Upon completion of your probationary period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.

EEO Statement/Policy: The United States government does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service or other non-merit factor. More information can be found here: https://www.justice.gov/jmd/media/1425556/dl?inline.

DOJ Reasonable Accommodation Policy: Federal agencies must provide reasonable accommodation to applicants with disabilities where appropriate. Applicants requiring reasonable accommodation for any part of the application and hiring process should contact the hiring agency directly. Determinations on requests for reasonable accommodation will be made on a case-by-case basis. The DOJ Reasonable Accommodation policy can be found here: https://www.justice.gov/jmd/reasonable-accommodation#policy

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.

Note: In accordance with 5 U.S. Code § 9202(c) and 5 C.F.R § 920.201(b) certain positions are exempt from the provisions of the Fair Chance Act.

Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.

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 windowLearn 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.

How you will be evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

Your application will be evaluated and rated using Rule of Many procedures under 5 C.F.R. § 332.402 based onPreference eligibles will receive 5 or 10 points added to their score based on the adjudicated preference.All eligibles at or above the pre-determined including any preference eligibles with a service-connected disability of 10 percent or more, at any score, will be referred to the selecting official for consideration.

The selecting official will receive a sufficient number of names, when available, to consider at least three candidates per vacancy. If fewer than three eligible and available candidates per vacancy result, the referral will be expanded in accordance with DOJ's guidance on supplemental certification. The selecting official will adhere to veterans' preference rules and Rule of Many procedures when making selections.

You will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics):

Technical Competence

If you would like to preview the application questionnaire, please see: https://apply.usastaffing.gov/ViewQuestionnaire/13013544

Required Documents

It is your responsibility to carefully review the list of required documents below and submit the necessary documentation based on your eligibility.

Resume
Transcript

Resume - All Applicants: You must submit a resume (a two page or less resume is required) containing the following pieces of information for each job entry listed in your employment history:

Official position title,
Employer name and contact information,
Start and end dates (including month and year),
Indicate full-time or number of hours worked per week if part-time, and
A list of duties performed and accomplishments.

Veterans' Preference documentation: If you are claiming veterans' preference you must submit:
(1) a copy of your DD-214, "Certificate of Release or Discharge from Active Duty," (Member 4 copy), showing the dates of active duty, type of discharge, and character of service, OR

(2) a certification letter from the armed forces that certifies you are expected to be discharged or released from active duty service in the armed forces under honorable conditions no later than 120 days after the date the certification is submitted. This letter must contain (a) military service dates including the expected discharge or release date and (b) character of service.
If you are claiming 10-point veterans' preference as a Disabled Veteran, Purple Heart Recipient, or Mother or Spouse of a Disabled or Deceased Veteran, in addition to the documents specified above, you must submit all additional proof required by the SF-15, and if applicable, a completed SF-15.

CTAP/ICTAP eligibility documentation - If you are a displaced Federal employee claiming eligibility under CTAP or ICTAP, you must submit:

A copy of the agency notice (i.e., letter of intent, separation notice, or agency RIF letter),

Your most recent performance appraisal, and

Most recent SF-50 showing current/former position, grade, promotion potential, and duty location.

See USAJOBS' Career Transition Programs for more information.

College Transcripts - If you are using education to qualify for this position, or education is required, you must submit: An unofficial transcript containing a full listing of courses, credit earned, grade and grade-point-average, subject area, degree(s) earned, and dates of award. Note: If you are selected for this position, official transcripts will be required prior to your first day.

How to Apply

To apply for this position, you must complete the online application questionnaire and submit your supporting documentation. Your complete application package must be submitted by 11:59 PM (EST) on 08/17/2026 to receive consideration.

The application process is as follows:

Click Apply to access the online application. You will need to be logged into your USAJOBS account to apply. If you do not have a USAJOBS account, you will need to create one before beginning the application.
Follow the prompts to select your resume and/or other supporting documents to be included with your application package. You will have the opportunity to upload additional documents to include in your application before it is submitted. Your uploaded documents may take several hours to clear the virus scan process.
After acknowledging you have reviewed your application package, complete the Include Personal Information section as you deem appropriate and click to continue with the application process.
You will be taken to the online application which you must complete in order to apply for the position. Complete the online application, verify the required documentation is included with your application package, and submit the application.

Essay Questions: The following four narrative questions provide an opportunity for you to highlight your dedication to public service for the hiring manager and agency leadership (or designee(s)). While your responses are not required and will not be scored, we encourage you to thoughtfully address each question. Please provide a response of 200 words or less to each question (see the application questionnaire). You will be asked to certify that you are using your own words and did not use a consultant or artificial intelligence (AI) such as a large language model (LLM) like ChatGPT or Copilot.

- How has your commitment to the Constitution and the founding principles of the United States inspired you to pursue this role within the Federal government? Provide a concrete example from professional, academic, or personal experience.

- In this role, how would you use your skills and experience to improve government efficiency and effectiveness? Provide specific examples where you improved processes, reduced costs, or improved outcomes.

- How would you help advance the President's Executive Orders and policy priorities in this role? Identify one or two relevant Executive Orders or policy initiatives that are significant to you, and explain how you would help implement them if hired.

- How has a strong work ethic contributed to your professional, academic or personal achievements? Provide one or two specific examples, and explain how those qualities would enable you to serve effectively in this position.

Need Help?
If you need help with USAJOBs or the application process, please see the USAJOBS Help or Application Manager Online Help websites which includes information on managing your account, creating an application, uploading documents, etc.

Reasonable Accommodation: To request reasonable accommodation for any part of the application and hiring process, please contact Brandon Cox at [email protected] for assistance.

Agency contact information

Brandon Cox

Phone

202-598-9544

Fax

202-514-7968

[email protected]

Next steps

You will receive e-mail notifications as your application status is updated by DOJ. However, you can also see your application status any time by logging in to your USAJOBS account and looking on the "Applications" page. Click the position title to expand the display for each application in the list.

We strive to extend a final offer of employment within 90 days from the close of this announcement. Additional selections may be made from this announcement.

Overview

Accepting applications

Location

1 vacancy in the following location:

Washington, DC

No matching locations found.

Work site options

Telework eligible

Yes—as determined by the agency policy.

Remote job

Relocation expenses reimbursed

Salary

$169,279 - $197,200 per year

Pay scale & grade

GS 15

Promotion potential

None

Learn more about pay scale and grade

Pay scale and grade determines the salary of the job.

Work schedule

Full-time

Travel Required

Not required

Appointment type

Permanent

Occupations and job series

0601 General Health Science

Supervisory status

Federal service type

This job is in the Competitive Service

Represented by a union

Drug test

Yes

Security clearance

Secret

Position sensitivity and risk

Moderate Risk (MR)

Jobs require a background check and some require a security clearance. The type depends on the job.

Background check type

Suitability/Fitness

Financial disclosure required

Some jobs require financial disclosure to identify conflicts of interests.

Announcement number

DE-13013544-26-BLC

Control number

877149500

Apply Now

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Summary

This job is open to

The public

Clarification from the agency

Duties

Requirements

Conditions of employment

Qualifications

Education

Additional information

Benefits

How you will be evaluated

Required Documents

How to Apply

Agency contact information

Next steps

Overview

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