This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare (CM), Medicare Parts C and D Oversight and Enforcement Group (MOEG). As a Supervisory Health Insurance Specialist, GS-0107-15, you will be responsible for developing a national program integrity audit strategy for Medicare health plans, including Part C and Part D, and overseeing oversight for various Medicare contractors.

Duties

Performs full range of supervisory duties for employees in the Medicare Parts C and D Oversight Enforcement Group (MOEG) to develop a comprehensive program integrity audits and strategies for the Medicare Health care plans. Directs and plan special studies and projects to analyze, and evaluate Medicare Part C, Part D, PACE plans and other Medicare health care plans performance data to improve the effectiveness of plan program operations Leads policy and requirements development for an effective oversight program for Part C, Part D, PACE, and other Medicare health plans. Interprets regulations and policies that impact national audit or oversight policy, operations, and internal and external stakeholders.

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-15, 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-14 grade level in the Federal government, obtained in either the private or public sector, to include: (1) managing or directing the evaluation or interpretation of health insurance laws, regulations, or policies for continuous improvement of health care oversight programs; (2) directing compliance or audit requirements related to Medicare private health plans including Parts C & D, or PACE plans; AND, (3) directing and leading work activities of employees or teams to ensure that program operational goals are met. 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.

Education

Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/12405103

Contacts

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