About this role
Job SummaryThis position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicaid and CHIP Services (CMCS). As a Supervisory Health Insurance Specialist, GS-0107-14, you will lead Medicaid managed care operations, supervise multidisciplinary staff, oversee waiver and contract reviews, and provide technical guidance on Medicaid, CHIP, and BHP policies and compliance.
QualificationsALL 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 staff, projects, and resources to ensure work is completed accurately, efficiently, and on time while supporting the overall goals and operations of the organization; 2. Overseeing State-administered Medicaid healthcare programs, to ensure policies, procedures, and program operations follow required Federal rules and regulations; AND 3. Identifying and resolving challenging program issues, keeping leadership informed of potential concerns, recommending appropriate corrective actions, and providing guidance and support to staff, state partners, and other stakeholders on Medicaid Managed Care policies and 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/12965952
Major DutiesSupervising multidisciplinary staff overseeing Medicaid managed care operations, assigning work, evaluating performance, managing personnel actions, and directing workforce planning and training.Directing oversight of Medicaid managed care programs, including 438.6(c) proposals, 1115 demonstrations, 1915 waivers, state contracts, and operational improvement initiatives.Providing technical guidance and policy interpretation on Medicaid, CHIP, and BHP managed care regulations, state operations, and federal compliance requirements.Leading project management, policy analysis, and stakeholder coordination activities, preparing briefing materials and translating complex managed care policies for senior leadership and partners.