This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare (CM), Medicare Plan Payment Group (MPPG). As a Health Insurance Specialist, GS-0107-14, you will provide guidance and support to the Group Director on a vast array of Medicare payment policies concerning Medicare Advantage and prescription drug plan payment; review and assess programs and policies; and develop responses to program data

Duties

Provides expert guidance on modifications to bidding, payment and other Medicare Advantage and prescription drug plans special needs and employer and union-sponsored retiree plans, demonstration plans, and other plans that serve unique populations. Conducts program-related studies and data analysis regarding program oversight, program payments, coordination or payments, program policy analysis that provides decision makers with technical data Maintains relationships, and participates in meetings with stakeholders to provide information concerning ongoing and proposed activities that may affect Medicare Parts C and Parts D plans. Consults and advises the Director on policies, operational procedures and critical issues which have a major impact on Medicare Advantage (MA) and Part D plans. Performs studies and data analysis to assess the impact of proposed policies and changes on current or future operations and program decisions.

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-14, 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-13 grade level in the Federal government, obtained in either the private or public sector, to include: (1) Conducting research to analyze data, laws, and regulations regarding Medicare Advantage and/or Part D payment; and (2) Assessing Medicare Advantage and/or Part D program activities to formulate recommendations; and (3) Communicating technical and detailed information to the health care industry, and policy officials in a variety of formats. 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/12432792

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]