This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare (CM), Medicare Drug Benefit C & D Data Group (MDBG). As a Health Insurance Specialist, GS-0107-14, you will serve as expert in identifying and correcting Part D non-compliance, oversees programs protections, and serve as a liaison to account managers, business owners, contractors, and other interagency groups.

Duties

Serves as a subject matter expert (SME) to develop, monitor, and evaluate policies and operations necessary for oversight, quality, and patient safety under Medicare Part D. Advise CMS leadership on prescription drug issues, including pharmacy benefit management, performance improvement, overutilization, marketplace dynamics, program strategy, program integrity, industry relations, and innovation. Oversees projects as SME for clinical and operational management of the Medicare prescription drug benefit as established under Part D of Title XVIII of the Social Security Act. Represents CMS and departmental task forces, workgroups, and other bodies to review policies and guidelines and recommend changes where appropriate regarding Medicare prescription drug policy and operations.

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. Assessing policies to oversee the Medicare prescriptions drug benefit program. 2. Making recommendations based on the assessment of policies to leadership and interested parties. 3. Providing technical direction on projects related to the drug benefit program. 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/12335444

Contacts

• Address Center for Medicare 7500 Security Blvd Woodlawn, MD 21244 US
• Name: CMS HR Inquiries
• Email: [email protected]