This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Federal Coordinated Health Care Office,(FCHCO), Models, Demonstrations & Analysis Group (MDAG). As a Health Insurance Specialist, GS-0107-13, you will serve as an expert in planning, developing, evaluating and making recommendations on financial issues and rate-setting for health plans and other models of integrated care for Medicare-Medicaid enrollees.

Duties

Identifies, analyzes, prioritizes, and resolves issues and problems related to rate-setting and financial analysis for new and/or existing delivery systems for Medicare-Medicaid enrollees. Provides expert technical assistance in rate-setting and other financial issues with state officials, health plans, and other interested stakeholders. Clearly and concisely presents analyses, policy implications of findings, and/or recommendations to senior level CMS officials and external parties in writing and/or verbally.

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-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) Collaborating on projects that apply principles and concepts of health care financing; 2) Conducting complex analyses using health care data systems and sets (e.g. fee for service claims and/or encounter data); AND 3) Presenting data, justification, and recommendations, for senior leadership/executive review and consideration. 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 or former Federal employees and current or former Federal employees applying under the VEOA eligibility who hold or have held a permanent General Schedule position in the previous year 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/12206913 *NOTE: This announcement has a cut-off of 150 applicants. The announcement will close at 11:59 p.m. on the date that the applicant cut-off is reached. Therefore, this announcement may close sooner than 11/27/2023.

Education

This job does not have an education qualification requirement.

Contacts

• Address Federal Coordinated Health Care Office 7500 Security Blvd Woodlawn, MD 21244 US
• Name: CMS HR Inquiries
• Email: [email protected]