This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Consumer Information and Insurance Oversight, (CCIIO). As a Health Insurance Specialist (Program Oversight), GS-0107-13, you will perform program oversight of external CMS stakeholders who provide services in support of CMS' lines of business, such as, Marketplace Exchange/Private Health Insurance, and Providers.

Duties

Provide expert analysis to examine, analyze, develop and interpret Medicare or Medicaid policy and program operations. Provide oversight strategy and processes and maintain operational requirements for overseeing entities that provide health care and prescription drug services. Identify program vulnerabilities and ensures continuing compliance with Agency agreements, contracts, statutory, regulatory and sub-regulatory requirements are met. Interpret policy to Agency internal and external stakeholders regarding compliance, audit and oversight programs. Develop health care policies and legislation in order to draft related policy documents, regulations, procedures and guidance to states.

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-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) Developing oversight strategies of health care or prescription drug service providers; (2) Evaluating methods used to identify vulnerabilities in a national health insurance program; and (3) Analyzing research or data to propose improvements to a health insurance 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 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/12430320

Education

This job does not have an education qualification requirement.

Contacts

• Address Center for Consumer Information and Insurance Oversight 7500 Security Blvd Woodlawn, MD 21244 US
• Name: CMS HR Inquiries
• Email: [email protected]