Posted 2d ago

Health Insurance Specialist (Program Oversight)

@ Centers for Medicare & Medicaid Services
Denver or Washington or Atlanta or Woodlawn or Kansas City or Philadelphia or Dallas
$91k-$118k/yrOnsiteFull Time
Responsibilities:Draft policies, Monitor stakeholders, Analyze data
Requirements Summary:GS-13 level; 1 year of specialized experience in health insurance program oversight; experience analyzing program data and overseeing health care programs.
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Job Description
Security Clearance

Not Required

Duties

Draft and review health care policies, regulations, and guidance documents to ensure compliance with statutory and regulatory requirements.,Monitor and evaluate external CMS stakeholders across Medicare, Medicaid, CHIP, and Marketplace programs for compliance and performance.,Analyze programmatic and operational data to assess program effectiveness and recommend improvements.,Collaborate with internal and external stakeholders to plan and execute program oversight activities.

Qualifications

ALL QUALIFICATION REQUIREMENTS MUST BE MET WITHIN 30 DAYS OF THE CLOSING DATE OF THIS ANNOUNCEMENT. Your resume (limited to no more than 2 pages) 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 being considered further. 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.Contributing to oversight strategies for health care programs, prescription drug services, or health insurance programs; AND 2. Analyzing programmatic, policy, or operational data to evaluate the quality and effectiveness of health insurance, health care delivery, or related program operations. 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/12951765

Other Information

Bargaining Unit Position: Yes-American Federation of Government Employees, Local 1923 Tour of Duty: Flexible Recruitment Incentive: Not Authorized Relocation Incentive: Not Authorized Financial Disclosure: Not Required OPM GS Pay Table: Atlanta GA. $112-556-$146,325 Dallas TX. $115,711-$150,426 Denver CO. $118,675-$154,280 Kansas City MO. $108,173-$140,627 Philadelphia PA. $117,284-$$152,471 Washington DC./Woodlawn, MD. $121,785- $158,322 Workplace Flexibility at CMS: This position has a regular and recurring reporting requirement to the CMS office listed in this announcement. CMS offers flexible working arrangements and allows employees the opportunity to participate in alternative work schedules at the manager's discretion. The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced federal employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit the required documentation and be rated well-qualified for this vacancy. Click here for a detailed description of the required supporting documents. A well-qualified applicant is one whose knowledge, skills and abilities clearly exceed the minimum qualification requirements of the position. Additional information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website at www.opm.gov/rif/employee_guides/career_transition.asp.