This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare (CM), Medicare Plan Payment Group (MPPG). As a Health Insurance Specialist, GS-0107-15, you will serve as the senior technical advisor, national expert, and lead on a vast array of policies related to the Medicare Advantage program and the Prescription Drug plan.

Duties

Provides expert guidance and executive leadership on the development of policies related to bidding and payment for Medicare Advantage and Part D organizations. Provides authoritative expert guidance on modifications to bidding, payment and other policies that are necessary for special needs plans, employer and union-sponsored retiree plans, demonstration plans, and other plans that serve unique populations. Functions as the principal technical specialist inthe assigned program area(s) and may lead teams from the same or other components. Calculates risks to further the Center’s productivity and outcomes, knowing the broader dynamic and typical organizational constraints. Provides information and justification on specific policies being proposed, for example, policies related to bidding and payment for Medicare Advantage Organizations and Part D sponsors.

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: 1. Interpreting laws and policies of existing and pending legislation of Medicare payment processes to provide guidance to management and other stakeholders; 2. Advising senior management on the impact on critical issues in the health insurance industry in order to assist in making program decisions; 3. Providing direction to staff to develop guidance documents, policy briefs, and standard operating procedures for the implementation or changes to those policies; AND 4. Analyzing new or revised changes to legislation to assess the impact on healthcare policies. 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/12289367

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]