Health Insurance Specialist
What you'd do
This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS). As a Health Insurance Specialist, GS-0107-13, you will develop, evaluate and implement compliance, audit and oversight requirements, policies, operating procedures related to activities and processes involved with the monitoring and oversight of external CMS stakeholders who contract or provide services in support of CMS' lines of business.
Major duties
Leads tasks designed to develop, evaluate, and implement Medicare, Medicaid and Children's Health Insurance Program (CHIP), Marketplace Exchange, and private health insurance programs. Develops, implements, and maintains operational requirements, including standard operating procedures for oversight of entities that provide health care and prescription drug services. Develops and reviews health care policies and legislation in order to draft related policy documents, regulations, procedures and guidance to states. Conducts analytical studies and evaluates the effectiveness of program initiatives by gathering, organizing, and interpreting data. Attends meetings and conferences with CMS staff and serve as a source of background data on the basis of research performed in preparation for the meetings and conferences.
What you need to qualify
ALL QUALIFICATION REQUIREMENTS MUST BE MET BY 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) Developing oversight strategies of health care or prescription drug service providers; (2) Evaluating methods used to identify vulnerabilities in a national health insurance program; and (3) Analyzing research or data to propose improvements to a health insurance program.. 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. Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/13006139
Before you apply
Federal applications are different: your resume should be 3–5 pages and mirror the language of this announcement. Read our federal resume guide first — it's the #1 reason qualified people get screened out.
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