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 (DHPO). As a Health Insurance Specialist, GS-0107-13, you will evaluate and implement policies related to activities and processes involved with the monitoring and oversight of external CMS stakeholders who contract or provide services in support of CMS' lines of business.

Duties

Develop, implement, and maintain operational requirements, including standard operating procedures, as well as databases to manage and analyze programmatic information such as routine and ad hoc report, deliverables, and programmatic documentation. Gather and analyze information, conduct various reviews and studies to assess ongoing operations, program vulnerabilities and initiating/ recommending improvements or appropriate action. Respond to inquiries regarding program oversight activities to a variety of internal and external stakeholders. Establish and maintain contacts and working relationships with both internal and external stakeholders required to plan and execute tasks. Respond to inquiries regarding program activities to a variety of 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.
• 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) Serving as a liaison to investigate and resolve stakeholder problems and complaints related to health insurance programs such as Medicare, Medicaid, and Marketplace Exchange or private health insurance; AND (2) Monitoring a health insurance program to make recommendations for program improvement. 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/12427300

Education

This job does not have an education qualification requirement.

Contacts

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