Health Insurance Specialist (Program Oversight)

Summary This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS). As a Health Insurance Specialist (Program Oversight), GS-0107-12, you will develop, evaluate, and implement compliance, audit and oversight requirements, policies, operating procedures related to monitoring and oversight of external CMS stakeholders who contract or provide services in support of CMS' lines of business. Responsibilities Develop, implement, and maintain a comprehensive program oversight strategy and processes for overseeing entities that provide health care and prescription drug services. Establish and maintain relationships with internal and external stakeholders to resolve problems pertaining to program oversight. Gather and analyze information, conduct various reviews and studies to assess ongoing operations, program vulnerabilities, and initiate/recommend improvements or appropriate action. Prepare a variety of written products, including position papers, manuals, reports, correspondence, briefing materials, etc. for the assigned program area. Requirements Conditions of Employment Qualifications 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-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) Modifying oversight processes of health care or prescription drug service providers; 2) Monitoring entities for compliance with health insurance program regulations and policies; and 3) Conducting reviews to assess health insurance program 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. Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/13043455 Education Additional Information Bargaining Unit Position: Yes - American Federation of Government Employees, Local 1923 Tour of Duty: Flexible Recruitment Incentive: Not Authorized 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. CMS offers flexible working arrangements and allows employees the opportunity to participate in alternative work schedules at the manager's discretion. Salary Ranges by Location: Atlanta, GA - $94,654 - $123,052 Boston, MA - $101,375 - $131,790 Chicago, IL - $100,059 - $130,080 Dallas, TX - $97,307 - $126,502 Denver, CO - $99,800 - $129,742 Kansas City, MO - $90,968 - $118,261 New York, NY - $105,481 - $137,128 San Francisco, CA - $111,896 - $145,468 Seattle, WA - $100,602 - $$130,786 Woodlawn, MD - $102,415 - $133,142 For more information about pay based on locality, please visit the Office of Personnel Management (OPM) Salaries & Wages Page. 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. Click here for a detailed description of the required supporting documents. 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 www.opm.gov/rif/employee_guides/career_transition.asp.