This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare, Medicare Plan Payment Group (MPPG)/Division of Payment Analysis & Policy (DPAP). As a Health Insurance Specialist (Program Policy), GS-0107-13, you will perform program policy work related to national health insurance programs, such as Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and private health insurance.

Duties

Serve as an expert in interpreting statute and developing Federal regulations, policy statements, and other program guidance relating to national health insurance programs. Identify and propose modifications to policies to reflect changes or trends in the health care industry. Conduct analysis of policy issues and topics by researching background information, the origin of laws, and the intended impact in order to make effective policy recommendations. Develop, evaluate, refine and review regulations, rulings, manuals, program guidelines, program memoranda, policy letters, and/or instructions to effectively communicate and disseminate program policies, Develop, implement, and maintain operational requirements, including standard operating procedures, as well as databases to manage and analyze programmatic information.

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.

Qualifications

ALL QUALIFICATION REQUIREMENTS MUST BE MET BY 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-13, 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-12 grade level in the Federal government, obtained in either the private or public sector, to include: (1) Conducting analysis of program payment or coverage policy for healthcare services in order to propose policy modifications; (2) Presenting recommendations based on analysis of program or coverage payment policy issues for healthcare services that describe feasible options and/or consequences; AND (3) Developing program guidance to manage and analyze programmatic information for payment or coverage of healthcare services. . 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. Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/12194248

Education

This job does not have an education qualification requirement.

Contacts

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