This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid Innovation, State and Population Health Group (SPHG), Division of Multi-Payer Models (DMPM). As a Lead Health Insurance Specialist, GS-0107-14, you will serve as a Lead Health Insurance Specialist for DMPM, working directly with the division director, deputy director, and model teams.

Duties

Review Medicare, Medicaid, CHIP, and private health insurance policies and legislative initiatives related to the development of state-based healthcare transformation for potential impact on DMPM models. Direct and lead analysis of expenditure, utilization, and quality data to support the design, development, and operationalization of new and existing multi-payer payment and service delivery models Provide technical direction to division staff, including guidance related to decisionmaking on nuanced and complex policy and to managing complex relationships with multiple stakeholders involved in the delivery and payment of healthcare. Prepares budget and resource requests, including estimates of costs and benefits for multi-payer models. Maintains continuing contacts and working relationships with counterparts in other government agencies, trade organizations, and private research institutions who are working in the same related fields and interprets CMS model policies for them.

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) Coordinate and lead activities to design and execute payment and service delivery models in the context of state healthcare transformation; AND 2) Direct and lead data analysis, development of technical and financial specifications, examination of provider incentives, and establishment of quality benchmarks in payment and service delivery models; AND 3) Mentor staff to help them better understand the necessary strategy, policies, regulations, and infrastructure to transform healthcare in a state; AND 4) Manage complex relationships with multiple stakeholders, including Federal and state government officials, providers, payers, consumers, and contractors. 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/12574339

Education

This job does not have an education qualification requirement.

Contacts

• Address Center for Medicare and Medicaid Innovation 7500 Security Blvd Woodlawn, MD 21244 US
• Name: CMS HR Inquiries
• Email: [email protected]