This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare (CM), Performance Based Payment Policy Group (PBPPG), Division of Accountable Care Organization Finance and Data Analytics (DAFDA). As a Health Insurance Specialist, GS-0107-13, you will serve as a specialist on issues related to the CMS Shared Savings Program, ACOs, and the integration of these concepts into the value-based payment systems.

Duties

Develops and reviews health care policies and evaluates legislation and program issues to draft related policy documents, regulations procedures and guidance for the Shared Savings Program. Develop and implement operational procedures to mitigate impacts of improper payments resulting from fraud or similar fault and significant, anomalous, and highly suspect billing on Shared Savings Program calculations. Attend briefings, meetings and conferences with CMS staff and prepare and present background data, and findings from research and analysis performed in preparation of those meetings. Respond to inquiries about the Shared Savings Program financial methodology and operations to a variety of internal and external stakeholders. Reviews and comments on new or proposed policy revisions, regulations, administrative sanctions, and legislation to determine their impact on the Shared Savings Program 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 this GS-13 position: you must clearly 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) Collaborating with stakeholders to gather information for policy development; and (2) Preparing written documents for senior officials such as draft regulations, background papers, fact sheets, briefing materials or presentations; and (3) Analyzing data and implement program integrity operations for healthcare programs. 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/12531878

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]