Health Insurance Specialist @ Centers for Medicare & Medicaid Services

Job Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Program Integrity. As a Health Insurance Specialist, GS-0107-14, you will serve as an advisor to the Director and Deputy Directors of CPI, providing technical guidance and staff-level project management for efforts associated with the development and implementation of program integrity policies and initiatives.

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-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.Leading or coordinating cross-cutting Medicare and/or Medicaid program integrity projects or initiatives across CMS Centers, Offices, or with external federal, state, or private entities; and 2 Analyzing Medicare and/or Medicaid laws, regulations, policies, or program data to identify vulnerabilities and determine their impact on program integrity operations, including fraud, waste, and abuse prevention or detection; and 3.

Developing written products such as briefing papers, memorandum, policy or option papers to advise senior officials on program integrity issues. 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/13089626

Major Duties

• Serving as a trusted advisor to the Center's Director and Deputy Directors on critical healthcare policy issues that impact billions in Medicare and Medicaid spending.
• Leading and coordinating the Center's highest priority projects that span multiple government agencies, Congressional offices, and healthcare industry partners.
• Representing CMS in high-level meetings with Congress, federal agencies, state governments, and healthcare industry leaders to build partnerships focused on preventing healthcare fraud.
• Analyzing emerging trends and issues in the healthcare sector that could impact Medicare, Medicaid, and CHIP programs.
• Creating comprehensive written materials, including policy recommendations and executive briefings, that influence major federal healthcare decisions.