Over 1 Million Paying Vacancies Available. Discover Your Dream Vacancy with Us!

Are you looking for a Health Insurance Specialist (Program Integrity)? We suggest you consider a direct vacancy at Centers for Medicare & Medicaid Services in Woodlawn. The page displays the terms, salary level, and employer contacts Centers for Medicare & Medicaid Services person

Job opening: Health Insurance Specialist (Program Integrity)

Salary: $117 962 - 153 354 per year
City: Woodlawn
Published at: Feb 14 2024
Employment Type: Full-time
This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Program Integrity (CPI). As a Health Insurance Specialist (Program Integrity), GS-0107-13, you will analyze, develop, and implement a wide range of program integrity initiatives that support CMS' lines of business through comprehensive program integrity reviews.

Duties

Lead tasks designed to develop, evaluate, and implement a wide range of program integrity initiatives and reviews to support CMS’ lines of business. Evaluate and analyze the impact of new or revised changes to legislation before the Congress pertaining to any CMS program. Research, evaluate, identify, and propose modifications to policies that reflect changes or trends in the health care industry, program integrity initiatives, and the needs of beneficiaries. Attend meetings and conferences with CMS staff and serve as a source of background data on the basis of research performed in preparation for the meetings and conferences

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: Evaluating health insurance program vulnerabilities to detect fraud, waste, or abuse; AND Collaborating across organizational lines on investigations, audits, or oversight of health insurance programs; AND Proposing policy changes relating to program integrity. 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/12308602

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]

Map

Similar vacancies

Supervisory Health Insurance Specialist Jan 24 2024
$163 964 - 191 900

Serves as a technical expert and advisor to the CMS leadership at the Group, Center, and Agency level on DIS operations. Uses viable information, data, and ...

Supervisory Health Insurance Specialist Jan 17 2024
$163 964 - 191 900

Provides expert leadership to the division in developing and implementing national policies for Medicare Parts A, B, C, and D beneficiary eligibility policies. ...

Supervisory Health Insurance Specialist Jul 30 2024
$163 964 - 191 900

Direct the activities necessary to ensure the successful completion of planning, development, and implementation of new and/or innovative program management for DAN based heavily in continuous improve...

Supervisory Health Insurance Specialist Apr 24 2024
$163 964 - 191 900

Provides business operations, direction and oversight for program implementation efforts, including efforts to improve organizational effectiveness and efficiency in leading and executing large nation...

Supervisory Health Insurance Specialist Feb 07 2024
$163 964 - 191 900

Develops regulations and guidance relating to assigned areas. Provides expert consultation to staff and leadership on technical and policy issues, defines i...