This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare (CM), Medicare Contractor Management Group (MCMG), Southern MAC Program Management Division (SMPMD). As a Health Insurance Specialist, GS-0107-14, you will serve as a Contracting Officer's Representative (COR) providing information and analysis on emerging issues associated with the Medicare claims processing and payment areas of expertise.

Duties

Perform analyses of operational policy and program operations to evaluate the appropriateness, cost effectiveness, or other impact resulting from the implementation of law, regulations, policy, or operational procedures and systems. Serve as a resource person for analysts within CM, CMS, HHS, and congressional staffs within the assigned areas of responsibility. Represent senior CM officials in discussions with CMS and Departmental officials, congressional staffs, interest groups that represent health organizations to explain and justify Medicare operational policy and program operations. Function as the COR for assigned MAC contracts providing expertise for all functions performed by such contractors and administration of such contracts. Plan and develop the detailed specifications for the MACs, including the direction, operation, and implementation requirements.

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.
• Must be able to obtain and maintain a COR III Certification.

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 this GS-14 position, you must clearly 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) Administering health-related or insurance-related contracts; and (2) Developing or evaluating Medicare policies or contracts; and (3) Leading projects or teams related to contract administration. 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/12346326

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]