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), in the Financial Operations and Oversight Group (FOOG). As a Technical Director for External Audit Resolution and Provider Designations, here referred to as Health Insurance Specialist, GS-0107-14, you will serve as a technical authority and program expert in both financial functions.

Duties

Provide complex technical assistance to CMS components on External Audit matters, including Medicare Administrative Contractor (MAC) specialized audits and implementation of instructions for audit resolution. Conduct analyses and complex studies of policies and programs that directly impact Financial Operations and Oversight Group’s functional areas across the country. Research, review, and report background information, including statutory and regulatory history, to identify and interpret guidelines and precedents relevant to the day-to-day operations and long-term strategic goals. Develop and coordinate the work of program task forces and work groups on intra-component and cross-component programs, issues, and problems, presents recommendations to senior managers. Participate in and make key authoritative contributions to top-level discussions and planning sessions on management program policy development.

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) Performing program management functions that include policy, operations, and evaluation aspects of the Medicare, Medicaid or other health care programs; 2) Serving as a subject matter expert to providing technical advice or policy guidance regarding Medicare or other health care program laws and guidelines; and 3) Analyzing or interpreting Medicare or other health care program policies and regulations in order to resolve issues and provide recommendations. 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/12519555

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]