This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid Innovation (CMMI), Seamless Care Models Group (SCMG), Division of Health Plan Innovation (DHPI). As the DHPI Director, GS-0101-15, you will lead a staff responsible for designing, implementing, and operating innovative payment and delivery models specifically related to Medicare Advantage health plans.

Duties

Supervises a diverse professional and administrative staff. Directs, designs, and implements models to test approaches to improve Medicare Advantage (MA) plan policy and operations to achieve better care, better health, and lower costs. Serves as technical expert and resource to CMS leadership and other stakeholders on issues related to the design, implementation, and operations for tests of innovative alternative payment, benefit, and service delivery models in MA. Consultant and advisor to the Group Director and Agency and Departmental management on decisions and recommendations associated with innovative payment, benefit and service delivery models related to MA plan policy and operations. Directs research and demonstrations to support the development and implementation of alternative MA delivery systems. Directs research studies to advance the development and refinement of payment policy, including risk adjustment, for health plans. Directs projects teams to ensure project management, quality management, performance, risk/issue management are integrated within the program and closely followed.

Requirements

• You must be a U.S. Citizen or National to apply for this position.
• You will be subject to a background and suitability investigation.
• Time-in-Grade restrictions apply.

Qualifications

ALL QUALIFICATION REQUIREMENTS MUST BE MET WITHIN 30 DAYS OF THE CLOSING DATE OF THIS ANNOUNCEMENT. Your resume must include detailed information as it relates to the responsibilities and specialized experience for this position. Evidence of copying and pasting directly from the vacancy announcement without clearly documenting supplemental information to describe your experience will result in an ineligible rating. This will prevent you from receiving further consideration. In order to qualify for the GS-15, you must meet the following: You must demonstrate in your resume at least one year (52 weeks) of qualifying specialized experience equivalent to the GS-14 grade level in the Federal government, obtained in either the private or public sector, to include: Providing technical guidance to internal and external stakeholders on issues related to the development, implementation, or operations of alternative payment/benefit and service delivery models for Medicare Advantage health plans; AND Leading research and analysis efforts to support the development and implementation of alternative delivery systems and payment policies for Medicare Advantage; AND Managing staff and work associated with the designing and developing, implementing, operating, or monitoring of Medicare Advantage payment and delivery models. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community, student, social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. Time-in-Grade: To be eligible, current Federal employees must have served at least 52 weeks (one year) at the next lower grade level from the position/grade level(s) to which they are applying.

Education

Education Requirement: In addition to meeting the qualification requirements, all candidates must have the following educational requirements:

• Bachelor's or higher degree in behavioral or social science or related disciplines appropriate to the position; OR
• A combination of education and experience, i.e., some coursework in appropriate disciplines related to the position and some experience that, when combined, provided knowledge of one or more of the behavioral or social sciences equivalent to a major in the field; OR
• At least four years of appropriate experience that demonstrates knowledge of one or more of the behavioral or social sciences equivalent to a major in the field.
  

TRANSCRIPTS are required to verify satisfactory completion of the educational requirement listed above. Please see "Required Documents" section below for what documentation is required at the time of application.

Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/12164182

Contacts

• Address Center for Medicare and Medicaid Innovation 7500 Security Blvd Woodlawn, MD 21244 US
• Name: CMS HR Inquiries
• Email: [email protected]