Senior Medicare Contract Operations Specialist

Summary

This position is located in Unemployment and Programs Support. The incumbent works closely with the Medicare Contracting Officer's Representative (COR) on all Medicare related issues and studies.

This job announcement may be used to fill one or more vacancies.

This is a bargaining unit position.

This job is open to
The public

U.S. Citizens, Nationals or those who owe allegiance to the U.S.

Career transition (CTAP, ICTAP, RPL)

Federal employees whose job, agency or department was eliminated and are eligible for priority over other applicants.

Duties

As a Senior Medicare Contract Operations Specialist, you will:

• Assist the Medicare COR in the conducting of studies and reviews of the contractor designated to process Part B Medicare claims for the Railroad Retirement Board (RRB) to assure compliance with the contract and applicable laws and regulations.
• Assess contractor performance and operations in order to make recommendations to improve the effectiveness of operations or otherwise assist the Medicare COR in performance of contractor monitoring.
• Make recommendations involving renewal or termination of the contract; providing technical assistance to the contractor; and reviewing and commenting on the contractor's budget.
• Represent the RRB in contacts with outside organizations and groups interested in the program.
• Periodically travel to perform certain work assignments on-site at the contractor's location.
• Serve as backup to the COR when that person is unavailable.
• Participate in planning, directing, or coordinating the work of the lower level specialist.

Requirements
Conditions of employment

• Must be a U.S. Citizen
• Males born after 12/31/59 must be registered for Selective Service
• Suitable for Federal employment, determined by a background investigation
• May be required to successfully complete a probationary period
• Complete the initial online assessment and USAHire Assessment, if required

Qualifications

Minimum Qualifications for GS-13 level: One year of specialized experience equivalent to the GS-12 grade level in the Federal service. Specialized experience is experience conducting analyses, reviews, and evaluation of Medicare contractor operations, processes and procedures as they relate to Part B Medicare Claims operations. This experience must have equipped the candidate with the particular knowledge, skills and abilities to successfully perform the duties of this position.

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.

Education

There is no education substitution for this position.

Additional information

Reasonable Accommodation (RA) 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, based on your adjudication decision. 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:

INTERAGENCY CAREER TRANSITION ASSISTANCE PLAN (ICTAP):

• ICTAP provides eligible displaced Federal competitive service employees with selection priority for competitive service vacancies. You must be determined to be well-qualified for the vacancy to be eligible for special selection priority. After submission of an acceptable application which meets ICTAP eligibility, you will be determined to be well-qualified for a vacancy if your rating places you in the best qualified category.
• ICTAP eligibles must submit proof of eligibility for special selection priority. Please see the Required Documents section below for more information. Click here for more information on ICTAP.

If you are a male applicant who was born after 12/31/59 you are required to register under the Military Selective Service Act; the Defense Authorization Act of 1986 requires that you be registered or you are not eligible for appointment in this agency.

Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.

Benefits

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. Opens in a new windowLearn more about federal benefits.

Review our benefits

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.

How you will be evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

Your qualifications will be evaluated based on your application materials (e.g., resume, supporting documents), your responses on the application questionnaire, and your responses to all assessments required for this position. You will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics):

Applicants will be rated on the following competencies:

• Attention to Detail
• Decision Making
• Flexibility
• Integrity/Honesty
• Interpersonal Skills
• Reading Comprehension
• Reasoning
• Self-Management
• Teamwork

Overstating your qualifications and/or experience in your application materials or application questionnaire may result in your removal from consideration. Cheating on an assessment may also result in your removal from consideration.

Category rating procedures will be used to rank eligible candidates. Qualified candidates will be assigned to the following categories: Best Qualified, Qualified, and Minimally Qualified. Within each quality category, veterans' preference eligibles will receive selection priority over non-veterans.

The Category Rating Process does not add veterans' preference points or apply the "rule of three" but protects the rights of Veterans by placing them ahead of non-preference eligibles within each quality category. Veterans' preference eligibles who meet the minimum qualification requirements and who have a compensable service-connected disability of at least 10 percent will be listed in the highest quality category (except in the case of scientific or professional positions at the GS-09 level or higher).

Required Documents

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

• Resume showing work schedule, hours worked per week, dates of employment and duties performed. Resume must not exceed 2 pages. Applicants will be removed from consideration if their resume is longer than 2 pages. Please see "How to Apply" for additional information regarding the limit.
• Veterans' Documentation: If you are a veteran, you must provide a copy of your Record of Military Service (DD-214), and proof of your veterans' preference, if applicable. Veterans with a service connected disability must also submit a completed claim form SF-15 (click here for form) along with the required proofs. Go to FedsHireVets-Veterans Preference for more information.
• Interagency Career Transition Assistance Plan (ICTAP) documentation: If you are eligible under ICTAP, you must submit all required materials verifying your eligibility as listed in "Additional Information." These materials include:
• Proof of eligibility: You must submit documentation such as a separation notice or other required material; and
• SF-50: You must submit a copy of a recent Notification of Personnel Action, SF-50 that shows career or career-conditional competitive service status (Blocks #24 and #34 must be completed); and
• Performance Appraisal: You must submit your most recent performance appraisal, which must be rated at least fully successful or equivalent. (This is not required if you are eligible for ICTAP due to compensable injury or disability retirement.) The performance appraisal may also be used as part of the ranking process and/or to verify your responses to the questionnaire.
• Reasonable Accommodation: If you are requesting a reasonable accommodation to the USA Hire Competency Based Assessments, submit documentation to support your request, including the Reasonable Accommodation Request Form found here:

How to Apply

In accordance with the Merit Herit Plan, only resumes up to a total of two pages will be accepted. Applicants with resumes exceeding two pages will be removed from consideration.

Resumes must be legible so they can be reviewed for eligibility, minimum qualifications and other position requirements listed in the job announcement.

We recommend using a sans-serif font size like Lato, if available. Other widely available options are Calibri, Helvetica, Arial, Verdana, Open Sans, Source Sans Pro, Roboto or Noro Sans. Make your page margins 0.5 inches. Consider using 14-point size font for titles and 10-point for the main text in your resume. For additional guidance on what to include in your resume, please see USAJOBS Help.

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 submission of the required documentation specified in the Required Documents section. The complete application package must be submitted by 11:59 PM (ET) on the closing date of the announcement to receive consideration. The application process is as follows:

• To begin the application process, click the Apply Online button.

• Answer the questions presented in the application and attach all necessary supporting documentation.

• Click the Submit Application button prior to 11:59 PM (ET) on the announcement closing date.

• If you are required to complete any USA Hire Assessments, you will be notified after submitting your application. The notification will be provided in your application submission screen and via email. The notification will include your unique assessment access link to the USA Hire system and the completion deadline. Additionally, in USAJOBS you can click "Track this application" to return to your assessment completion notice.

• Access USA Hire using your unique assessment link. Access is granted through your USAJOBS login credentials.

• Review all instructions prior to beginning your assessments. You will have the opportunity to request a testing accommodation before beginning the assessments should you have a disability covered under the Rehabilitation Act of 1973 as amended.

• Set aside at least 3 hours to take the USA Hire Assessments; however, most applicants complete the assessments in less time. If you need to stop the assessments and continue later, you can re-use your unique assessment link.

• Your responses to the USA Hire Assessments will be reused for one year (in most cases) from the date you complete an assessment. If future applications you submit require completion of the same assessments, your responses will be automatically reused.

Visit the USA Hire Applicant Resource Center for practice assessments and assessment preparation resources at https://support-

To update your application, including supporting documentation: During the announcement open period, return to your USAJOBS account, find your application record, and click Edit my application. This option will no longer be available once the announcement has closed.

To view the announcement status or your application status: Click on this: Your application status page is where you can view your application status, USA Hire assessment completion status, and review your notifications sent by the hiring agency regarding your application.

Agency contact information

RRB Human Resources

Phone

Email

Address

Railroad Retirement Board

844 N Rush St

Chicago, IL 60611

US

Next steps

Once your online application is submitted you will receive a confirmation notification by email. After a review of your complete application is made, you will be notified of your rating and possible referral to the hiring official. If further evaluation or interviews are required you will be contacted.

Overview

Accepting applications

Open & closing dates

11/18/2025 to 12/02/2025

Salary

$90,025 to - $117,034 per year

This salary reflects the GS base rate and will be adjusted to include locality pay upon selection.

Pay scale & grade

GS 13

Location

1 vacancy in the following location:

Location Negotiable After Selection

Remote job

No

Telework eligible

Yes—As determined by the agency policy. THIS IS NOT A REMOTE POSITION.

Travel Required

25% or less - You may be expected to travel for this position.

Relocation expenses reimbursed

No

Appointment type

Permanent

Work schedule

Full-time

Service

Competitive

Promotion potential

13

Job family (Series)

• 0301 Miscellaneous Administration And Program

Supervisory status

No

Security clearance

Not Required

Drug test

No

Position sensitivity and risk

Moderate Risk (MR)

Trust determination process

• Credentialing
• Suitability/Fitness

Financial disclosure

No

Bargaining unit status

Yes

Announcement number

250022DE TH

Control number

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