This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Office of Program Operations & Local Engagement (OPOLE), Medicare Program Operations & Integrity Group, Division of Medicare Program Operations & Integrity. As a Health Insurance Specialist, GS-0107-13, you will serve as an expert in the development, evaluation, and implementation of policies with the monitoring, oversight and payment models of external CMS stakeholders.

Duties

Develop and review health care policies to draft related policy documents, regulations, procedures, and guidance. Conduct various reviews and studies to assess ongoing operations and program vulnerabilities. Respond to inquiries regarding program oversight activities and engage with internal and external stakeholders. Contribute to discussions and planning sessions on program oversight developments. Provide policy or technical direction to internal and external stakeholders.

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. Provide technical advice or policy guidance to health care providers or the general public regarding Medicare or other health care program laws and guidelines; AND 2. Analyze or interpret Medicare or other health care program policies and regulations in order to resolve issues and provide recommendations; AND 3. Examine performance through reviews or audits and document recommended plans of correction to address deficiencies or program vulnerabilities. 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/12549556

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]