Health Insurance Specialist

Summary

Department of Health & Human Services, Centers for Medicare & Medicaid Services, Center for Medicaid and CHIP Services, Financial Management Group (FMG), Division of Reimbursement Policy (DRP). As a Health Insurance Specialist, GS-0107-14, provides technical direction and leadership to a highly technical professional staff; and develops, implements, and evaluates Medicaid payment policies for services provided to Medicaid beneficiaries in institutional and non-institutional settings.

Duties

• Providing technical direction and leadership to a highly technical professional staff; and develops, implements, and evaluates Medicaid payment policies for services provided to Medicaid beneficiaries in institutional and non-institutional settings.
• Providing technical direction and leadership to a highly technical professional staff; and develops, implements, and evaluates Medicaid payment policies for services provided to Medicaid beneficiaries in institutional and non-institutional settings.
• Providing technical assistance to staff, States, contractors, etc., to resolve problems by participating in meetings, answering inquiries, going on-site, doing special analyses, providing training, refining instructions, etc.
• Serving as a technical management and team lead for Medicaid and CHIP operations, planning and coordinating activities related to Medicaid financial management oversight.

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. Developing and implementing program activities related to Medicaid fee-for-service payment and financial policy, including Medicaid institutional and non-institutional payment policy, and Medicaid state financing mechanisms; 2. Collaborating with internal and external stakeholders (e.g., Federal and state officials, contractors, and policy advocates) to provide technical guidance and recommendations on Medicaid/CHIP program administration and oversight; And 3. Authoring technical policy documents (e.g., issue papers, decision memoranda, briefing materials, or guidance documents) related to Medicaid fee-for-service payment and financing policy to inform leadership decisions and communicate program requirements. 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/13064619

How You Will Be Evaluated

You will be evaluated based on how well you meet the qualifications listed in this vacancy announcement. Your qualifications will be evaluated based on your application materials (e.g., resume, supporting documents), the responses you provide on the application questionnaire, and the results of the online assessments required for this position. A Subject Matter Expert will assist in the resume review process to help determine whether you meet the minimum job qualifications. Please follow all instructions carefully. Errors or omissions may affect your rating. You will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics): Attention to Detail Customer Service Decision Making Flexibility Influencing/Negotiating Integrity/Honesty Interpersonal Skills Learning Reading Comprehension Self-Management Stress Tolerance Teamwork In order to be considered for this position, you must complete all required steps in the process. In addition to the application and application questionnaire, this position requires an online assessment. The online assessment measures critical general competencies required to perform the job. Overstating your qualifications and/or experience in your application materials or application questionnaire may result in your removal from consideration. Cheating on the online assessment may also result in your removal from consideration. Other Information

Bargaining Unit Position: Yes 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. 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.