The Centers for Medicare & Medicaid Services has found two leaders from within the agency to spearhead technology and operations in Medicare and Medicaid, naming David Nelson CIO and Tim Love COO.

The two long-time CMS staffers, both former members of the military, replace two other long-time agency leaders and are overseeing the most significant health coverage and regulatory expansions in the agency’s history.

Coming from the CMS Office of Enterprise Management, Nelson became acting CIO following Tony Trenkle’s departure in November, as HealthCare.gov was struggling to accommodate consumers. Love, the deputy chief operating officer during the past two years, became acting COO when Michelle Snyder retired at the end of 2013, as the federal exchange was starting to improve.

[See also: CMS CIO to step down amid shakeup.]

After graduating from the University of Oregon with a degree in political science, Love served in the Navy and the Peace Corps and landed at HHS as a presidential management intern in 1991. He went on to work in the administration of the Medicare Advantage and prescription drug benefits programs, in the Center for Strategic Planning, and following passage of the Affordable Care Act in 2010 spent seven months as a policy director in the White House Office of Health Reform.

CMS Administrator Marilyn Tavenner said Love is bringing "broad experience to this role from within and outside our agency." Nelson, the new CIO, has spent 10 years with HHS and has "deep experience both as a manager and technologist to this critically important position," Tavenner said.

Nelson started his career in the Air Force in Japan, earned a business management degree from the University of Phoenix, co-founded two startups devoted to “last-mile” broadband access and worked in operations at the satellite communications company Loral-Orion. At CMS, Nelson directed the Office of Enterprise Management and the Data Analytics and Control Group.

Both of their careers span more than one president, and Love’s spans two names for the Medicare and Medicaid agency, from the Health Care Financing Administration to CMS.

[See also: CMS called out for EHR fraud failings.]

Both Love and Nelson oversee large budgets and have huge responsibilities in supporting the Medicare and Medicaid programs. Love states that he intends to "promote accountability, communication, coordination, and facilitation of cooperative corporate decision-making among CMS senior leadership on management, operational and programmatic cross-cutting issues."

The COO’s scope covers Medicare, Medicaid, federal marketplaces, state Medicaid waivers (and in 2017 universal coverage waivers), insurance and delivery regulations, and technology initiatives, and Love states that he “tracks and monitors CMS performance and intervenes, as appropriate, to ensure key milestones/deliverables are successfully achieved.”

Nelson’s Office of Information Services oversees technology deployed for CMS' internal operations, provider payment system, and public websites disclosing information, with eight different units, including the enterprise data group, the innovative healthcare delivery systems group, and the consumer information and insurance systems group.

To complement both the technology and oversight decision makers and other leadership at CMS, Marilynn Tavenner is creating a new position of chief risk officer.