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), Medicare Program Operations & Integrity Group. As a Health Insurance Specialist, GS-0107-14, you will serve as a technical authority and program expert in Medicare Program Integrity/Provider Enrollment (PI/PE), and Medical Review (MR).

Duties

Serve as a senior advisor to management and executive leadership on developing and implementing strategic plans in support of achieving the PI/PE and MR functional program objectives. Perform complex reviews, evaluations, and follow-up of key initiatives to assure that goals, objectives, and deadlines are met. Provide leadership on a variety of special assignments involving all aspects of the management of health care and/or health care financing programs and projects. Evaluate the effectiveness of existing policies and reviews new policy and legislative initiatives for potential impact on OPOLE and/or the Agency. Participate in and makes 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) Perform program management functions that include policy, operations, and evaluation aspects of Medicare, Medicaid or other health insurance programs; AND 2) Execute detailed analyses of health care program activities addressing areas of deficiency; AND 3) Plan and conduct comprehensive projects or studies outlining proposed recommendations based on findings. 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/12607461

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]