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 perform assignments associated with outreach and customer service aimed at private health insurance consumers, beneficiary/provider populations and interest groups, and other stakeholders.

Duties

Respond to routine inquiries regarding program-related activities to a variety of internal and external stakeholders (e.g., beneficiaries, providers, public and private organizations, congressional staff, and other government organizations). 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. Work with managers and subject matter experts to provide timely responses to the appropriate CMS component lead. Gather and analyze information, independently conducts various reviews and studies to assess ongoing operations and provide necessary recommendations. Recommend improvements based upon monitoring operations of a health insurance program. Establish and maintain contacts and working relationships with both internal and external stakeholders to provide information, guidance or coordination of health insurance program activities or operations.

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)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 Federal employees 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/12509049

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]