This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Program Integrity (CPI), Audits and Vulnerabilities Group. As a Health Insurance Specialist, GS-0107-15, you will serve as the key representative for all Medicaid and Marketplace Program Integrity (PI)- related work for CPI.

Duties

Acts as the technical lead over Marketplace administrative actions, with the goal of developing and maintaining a robust oversight strategy that takes administrative action against problematic agents and brokers. Provides technical leadership and direction to the Agency and in the development of guidance on Marketplace and Medicaid PI areas of concern. Coordinates work deliverables that form the basis of broad-ranging agency PI policies, processes, and strategies. Prepares or directs the preparation of written communications to address complex and comprehensive correspondence, memoranda, briefing papers, option papers, speeches, and program proposals for Group and Center leadership.

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 grade level, 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: Serve as the key technical authority and advisor in Marketplace or Medicaid oversight; and Develop program integrity policies and protections needed to safeguard the Marketplace or Medicaid from fraud, waste and abuse; and Develop Marketplace or Medicaid program integrity strategies and policies that facilitate the process for establishing and maintaining beneficial partnerships between an organization and its' external customers. 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/12480103

Education

This job does not have an education qualification requirement.

Contacts

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