This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Office of Burden Reduction and Health Informatics (OBRHI), National Standards Group (NSG). As a HEALTH INSURANCE SPEC, GS-0107-14, you will be the technical advisor repsonsible for improving compliance with the administration simplification provisions of HIPPA, the ACA and any subsequent legislation.

Duties

Improve compliance with the administrative simplification provisions of the Health Insurance Portability and Accountability Act (HIPAA), and the Affordable Care Act (ACA), and any subsequent legislation. Conduct program-related studies and data analysis regarding program oversight to determine compliance with program policy by the Medicare, Medicaid, and the health care system. Serve as the Business Function Lead/Government Task Lead (BFL/GTL) over the compliance and enforcement contractor. Oversee the compliance activities; monitors, reviews, evaluates, and assesses the integrity and quality of operations; prepares and analyzes health care data related to the programs; and performs other CMS program-related activities.

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) Provide comprehensive technical analysis on legislation and policies related to the Health Insurance Portability and Accountability Act (HIP AA); AND (2) Conduct data analysis to identity, assess, analyze, and improve compliant-based enforcement, the intake of audit requirements; AND (3) Produce written documents including briefing documents, reports, corrective action plans, and resolution agreements. 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/12312222

Education

This job does not have an education qualification requirement.

Contacts

• Address Office of Burden Reduction and Health Informatics 7500 Security Blvd Woodlawn Woodlawn, MD 21244 US
• Name: CMS HR Inquiries
• Email: [email protected]