This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Program Integrity (CPI), Division of Compliance and Appeals (DCA). As a Supervisory Health Insurance Specialist, GS-0107-14, you will serve as Deputy Division Director leading staff responsible for developing, managing, and coordinating determinations on provider and supplier enrollment corrective action plans (CAPs).

Duties

Assist in coordinating all facets of the Division's work by mobilizing a diverse staff of health insurance, program analysis, and program implementation professionals. Assist in reviewing and rendering determinations on provider and supplier enrollment corrective action plans (CAPs) and reconsiderations for providers and suppliers who are denied, revoked, challenge the effective date of enrollment approval. Assist in identifying vulnerabilities and implements policies directed at preventing fraud and abuse and to improve administrative efficiencies in Medicare and Medicaid enrollment of providers and suppliers. Work collaboratively with other CMS components to gauge the impact that development and implementation of demonstration projects that might improve the detection and prevention of fraud, waste, and abuse.

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-14, 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-13 grade level in the Federal government, obtained in either the private or public sector, to include: Leading provider and supplier enrollment projects or programs; AND Analyzing regulations and policies to determine the impact on program operations; AND Developing written products such as standard operating procedures, memos, policies, briefings, or manuals. 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. Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/12206709

Education

This job does not have an education qualification requirement.

Contacts

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