This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Office of Program Operations and Local Engagement (OPOLE), Drug and Health Plan Operations, and Innovation and Financial Management (IFM). As a Health Insurance Specialist, GS-0107-13, you will serve as an expert in the development, evaluation, and implementation of policies with the monitoring, oversight, and payment models of external CMS stakeholders.

Duties

Develop and review health care policies to draft related policy documents, regulations, procedures, and guidance. Conduct various reviews and studies to assess ongoing operations and program vulnerabilities. Respond to inquiries regarding program oversight activities and engage with internal and external stakeholders. Contribute to discussions and planning sessions on program oversight developments. Provide policy or technical direction to model participants.

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.
• This position may be eligible for telework in accordance with agency policy. You will be required to report on a regular and recurring basis to one of the CMS locations stated on this announcement.

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) Managing projects or studies to test models focused on Medicare Advantage or other health insurance programs; 2) Establishing effective working relationships with internal and external audiences to provide research findings or background data; AND 3) Evaluating activities of a health care entity or contractor to ensure adherence to program policies or requirements. 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/12328015

Education

There is no education substitution for this position.

Contacts

• Address Office of Program Operations and Local Engagement 7500 Security Blvd Woodlawn, MD 21244 US
• Name: CMS HR Inquiries
• Email: [email protected]