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Health Insurance Specialist

1 month ago

Riverdale, United States Centers for Medicare and Medicaid Services Full time

Duties
  • Interpret statute and develop Federal regulations, policy statements, and other program guidance. Propose modifications to policies to reflect changes or trends in the health care industry, program objectives and the needs of beneficiaries.
  • Conduct analysis of policy issues and topics, research background information, the origin of laws, and the intended impact in order to make effective policy recommendations.
  • Develop, evaluate, refine and review regulations, rulings, manuals, program guidelines, program memoranda, policy letters, and/or instructions to effectively communicate and disseminate program policies related to CMS' lines of business.
  • Prepare and coordinate a variety of written products, including position papers and briefing materials for senior officials to use as background information on program policy related activities.
  • Work with States, other key stakeholders, and CMS staff to identify and address evolving program issues or to provide guidance on programmatic matters.
Requirements
Conditions of Employment
  • You must be a U.S. Citizen or National to apply for this position.
  • You will be subject to a background and suitability investigation.


Qualifications

ALL QUALIFICATION REQUIREMENTS MUST BE MET BY 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-11, 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-09 grade level in the Federal government, obtained in either the private or public sector), to include:
  1. Assisting in conducting analysis of national or state health insurance program policy issues in order to propose policy modifications; AND
  2. Designing or implementing strategies or tools for healthcare participants to foster shared learning and drive adoption of healthcare initiatives; AND
  3. Collaborating to establish and implement goals, policies, or actions that increase or improve value-based healthcare or healthcare system transformation.
- OR -

Substitution of Education for Experience: You may substitute education for specialized experience at the GS-11 level by possessing a Ph.D. or equivalent doctoral degree or 3 full years of progressively higher level graduate education leading to such a degree or equivalent doctoral degree or LL.M., if related to the position being filled.

- OR -

Combination of Experience and Education: Only graduate education in excess of the amount required for the GS-09 grade level may be used to qualify applicants for positions at the grade GS-11. Therefore, only education in excess of a master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree, may be used to combine education and experience.

TRANSCRIPTS are required to verify satisfactory completion of the educational requirement related to substitution of education for experience and combination of experience and education. Please see "Required Documents" section below for what documentation is required at the time of application.

In order to qualify for the GS-12, 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-11 grade level in the Federal government, obtained in either the private or public sector, to include:
  1. Participating in teams or work groups for healthcare programs including conducting analysis of national or state health insurance program policy issues in order to propose policy modifications; AND
  2. Presenting recommendations and conclusions based on analysis and evaluation of health insurance programs that describe feasible options and/or the consequences; AND
  3. Presenting health insurance or related information orally, in writing, or by graphic illustration, to various levels of management, their representatives and/or staff.


Substitution of Education for Experience: There is no substitution of education to meet the specialized experience requirement at the GS-12 grade level.

Combination of Experience and Education: There is no combination of experience and education to meet the specialized experience requirement at the GS-12 grade level.

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:

Additional information

Bargaining Unit Position: Yes-American Federation of Government Employees, Local 1923

Tour of Duty: Flexible

Recruitment/Relocation Incentive: Not Authorized

Financial Disclosure: ???????Not Required

Workplace Flexibility at CMS: This position has a regular and recurring reporting requirement to the CMS office listed in this announcement; however, CMS offers flexible working arrangements and allows employees the opportunity to participate in telework combined with alternative work schedules at the manager's discretion. This position may be authorized for telework. Telework eligibility will be discussed during the interview process. Supervisory positions must report a minimum 2 times per week and non-Supervisory positions must report a minimum of 2 times per pay period.

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. . 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 .


  • A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. .

    Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.




Required Documents


To apply for this position, you must submit a complete Application Package which includes:

1. Resume showing relevant experience; cover letter optional. Your resume must indicate your citizenship and if you are registered for Selective Service if you are a male born after 12/31/59. Your resume must also list your work experience and education (if applicable) including the start and end dates. For work in the Federal service, you must include the series and grade level for the position(s). For resume and application tips visit: .

Your resume will be used to validate your responses to the assessment tool(s). We strongly encourage applicants to utilize the USAJOBS resume builder in the creation of resumes. Determining length of general or specialized experience is dependent on the information provided in the resume. Failure to include ALL of the information listed below on your resume WILL result in a finding of ineligible.

  • Official Position Title (include series and grade if Federal job)
  • Duties (be specific in describing your duties)
  • Employer's name and address
  • Supervisor name and phone number
  • Start and end dates in the month and year format (e.g. June 2007 to April 2008)
  • Full-time or part-time status (include hours worked per week)
  • Salary


2. CMS Required Documents (e.g., SF-50, DD-214, SF-15, etc.). Required documents may be necessary to be considered for this vacancy announcement. . Failure to provide the required documentation WILL result in an ineligible rating OR non-consideration.

3. College Transcripts. Although this position does not require a degree, you may substitute college credit in whole, or in part, for experience at specified grade levels. You must submit a copy of your transcript at the time of application in order to substitute your education for the required experience. If you do not submit a transcript, your education will not be considered in determining your qualifications for the position. You may submit an unofficial transcript or a list of college courses completed indicating course title, credit hours, and grades received. An official transcript is required if you are selected for the position.

College Transcripts and Foreign Education: Applicants who have completed part or all of their education outside of the U.S. must have their foreign education evaluated by an accredited organization to ensure that the foreign education is comparable to education received in accredited educational institutions in the U.S. For a listing of services that can perform this evaluation, visit the website. This list, which may not be all inclusive, is for informational purposes only and does not imply any endorsement of any specific agency.

4. Reasonable Accommodation Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments, if you received the link after the close of the announcement. To determine if you need a RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments here:

If you are relying on your education to meet qualification requirements:


Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from
.


Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.

How to Apply

Please read the entire announcement and all the instructions before you begin an application. To apply for this position, you must complete the initial online application, to include the initial online assessment and submission of the required documentation specified in the Required Documents section. The complete application package must be submitted by 11:59 PM (ET) on 06/04/2024 of the announcement to receive consideration. The application process is as follows:

  1. To begin the application process, click the Apply button. You will need to be logged into your USAJOBS account to apply. If you do not have a USAJOBS account, you will need to create one before beginning the application.
  2. Follow the system prompts in USAJOBS to select your resume and supporting documents; review your application package; include personal information; and continue the application process in the USA Staffing agency site.
  3. Answer the questions presented in the online application and attach all necessary supporting documentation in USA Staffing.
  4. Click the Submit Application button prior to 11:59PM (ET) on 06/04/2024.
  5. After submitting an online application, you will be notified whether or not you are required to take additional online assessments through the USA Hire Competency Based Assessment system. This message will be delivered to you via email notification. The email may be routed to your "Spam" or "Junk" folder.
  6. Note, set aside at least 3 hours to take these assessments; however, most applicants complete the assessments in less time. If you need to stop the assessments and continue at a later time, you can re-use the URL sent to you via email and also found by clicking the Track This Application link located in the application record in your USAJOBS account.


To update your application, including supporting documentation, at any time during the announcement open period, return to your USAJOBS account (). There you will find a record of your application, the application status, and an option to Edit My Application. This option will no longer be available once the announcement has closed.

To verify the status of your application both during and after the announcement open period, log into your USAJOBS account: . All of your applications will appear on the Welcome page. The application record in your USAJOBS account contains a Track This Application link that provides information regarding the documentation you submitted and any correspondence we have sent related to this application, including the invitation to take the USA Hire assessment. The Application Status will appear along with the date your application was last updated. For information on what each Application Status means, visit: .

Commissioned Corps Officers (including Commissioned Corps professionally boarded applicants) who are interested in applying for this position must send their cover letter and professional resume (not PHS Curriculum Vitae) to in lieu of applying through this announcement. The resume should specifically explain how you are qualified for this position and draw specific attention to your skills and experiences that demonstrates these qualifications. Also send any transcripts, licenses or certifications as requested in this announcement. Please send all documents in 1 PDF file. In the subject line of your e-mail include only the Job Announcement Number. In the body of your e-mail include your current rank name and serial number. Failure to provide this information may impact your consideration for this position.

Additional selections may be made for similar positions across the Department of Health and Human Services (HHS) within the local commuting area(s) of the location identified in this announcement. By applying, you agree to have your application shared with interested selecting official(s) at HHS. Clearance of CTAP/ICTAP will be applied for similar positions across HHS.

When the Department of Health and Human Services (HHS) completes its selections, the remaining list of qualified candidates may be shared with other federal agencies. You will have an opportunity to opt in if you would like your name, application material, and assessment results shared for consideration of employment with additional agencies. There is no guarantee of further consideration, and you can continue to explore other job opportunity announcements.

Agency contact information

CMS HR Inquiries

Email
Address
Center for Medicare and Medicaid Innovation

7500 Security Blvd

Woodlawn, MD 21244

US

Next steps


Based on your application and your responses to the application questionnaire, you may be presented with instructions on how to access the USA Hire system to complete the online assessments. The online assessments must be completed within 48 hours following the close of this announcement. You will have the opportunity to request a testing accommodation for the assessment should you have a disability covered under the Americans with Disabilities Act (ADA).

Your assessment results will be kept on record for one year and used toward future positions for which you might apply that require the same assessments.

Fair & Transparent


The Federal hiring process is set up to be fair and transparent. Please read the following guidance.

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