Health Insurance Specialist

Summary This position is located in the Department of Health & Human Services, Centers for Medicare & Medicaid Services, Center for Medicaid and Children's Health Insurance Program (CHIP) Services (CMCS). As a Health Insurance Specialist, GS-0107-13, serves as CMS' focal point for assistance with formulation, coordination, integration, and implementation of all national program policies and operations relating to (CHIP), and the Basic Health Program (BHP). Responsibilities Providing oversight and technical assistance to states on Medicaid, CHIP, and BHP delivery systems, waivers, State Plan Amendments, payment policies, and program implementation. Developing, analyzing, interpreting, and evaluating national policies, regulations, legislation, procedures, and guidance governing Medicaid, CHIP, BHP, and related health programs. Reviewing state financing, reimbursement, eligibility, benefits, prescription drug, third-party liability, and other program policies to ensure compliance with applicable requirements. Coordinating with states, territories, tribal organizations, Federal agencies, stakeholders, and Congressional staff to provide technical assistance, resolve program issues, and support policy implementation. Conducting program analyses, studies, data reviews, and evaluations to assess program performance, policy impacts, financial operations, integrity risks, and opportunities to improve care and reduce costs. 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-13, 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-12 grade level in the Federal government, obtained in either the private or public sector, to include: 1. Developing or implementing policies at the state or national level for Medicaid, CHIP, or other similarly scaled health services program; AND 2. Providing technical assistance on health policy and health program compliance and/or cost issues, AND 3. Drafting a variety of technical documents (i.e. health program policy issue and decision papers, and terms and conditions or other legal documents). 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/13039509 Education Additional Information Bargaining Unit Position: Yes Tour of Duty: Flexible Recruitment Incentive: Not Authorized Relocation Incentive: Not Aurthorized 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.