This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare (CM), Medicare Drug and Health Plan Contract Administration Group (MCAG), Division of Medicare Advantage Operations (DMAO) As a Health Insurance Specialist, GS-0107-14, you will serve as the technical advisor providing consultation to leadership to coordinate and implement required compliance with network adequacy standards during application cycles.

Duties

Represent the Staff and/or Center at briefings, hearings and other meetings throughout CMS and at other levels in government regarding the development and justification of application and network adequacy policies. Provide project direction and technical direction to lower-graded analysts, define individual team members task assignments, review team members work for technical accuracy, and recommend employees' technical training needs to the program manager. Provide expert analysis and advice on existing policies, procedures, law, and critical issues with regards to investigating, evaluating, approving and denying applications for Medicare Advantage. Function as the principal technical specialist in the assigned program area(s) and may lead teams from the same, or other components.

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: 1) Providing technical knowledge for initiatives and activities related to legislation, regulation and program policy; 2) Identifying potential improvements or changes to Medicare Advantage or other private health plans and making recommendations to implement such solutions; AND 3) Communicating technical or detailed information in a variety of formats such as regulations, briefing papers, presentations, or meetings, etc. 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/12302186

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]