As a Program Manager (Disputed Claims) at the GS-0340-15, you will be part of Healthcare and Insurance, Office of Personnel Management. If selected, you will be responsible for directing the Disputed Claims Team operations, including the scheduling, achievement, and performance review of the team.

Duties

Provides overall leadership for group planning, organizing, mentoring, and overseeing operations of the Disputed Claims office. Lead the procurement for the Independent Review Organization (IRO) contract for medical consultant reviews. Develops and evaluates standard operating procedures on disputed claims operations. Represents OPM in meetings with officials of other Federal agencies, public and private sector organizations, carriers or insurance companies.

Requirements

Qualifications

For the GS 15: You must have one full year of specialized experience comparable in scope and responsibility to the GS-14 level in the Federal service (obtained in public or private sectors), which includes performing ALL the following activities: Provide management oversight and control over a team adjudicating disputed claims; Ensure disputed claims process is in accordance with statutory and regulatory requirements; Handle staff and other complaints, settling disagreements and resolving conflicts; AND Review communications and letters on health benefits claims. Merit promotion applicants must meet the time-in-grade requirement as defined in 5 CFR 300, Subpart F. One year at the GS-14 level is required to meet the time-in-grade requirements for the GS15 level. You must meet all qualification and eligibility requirements within 30 days of the closing date of this announcement. 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.

Contacts

• Address OPM Human Resources 1900 E St., NW Washington, DC 20415 US
• Name: OPM Human Resources
• Phone: 202-606-9321
• Email: [email protected]