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This Position Is No Longer Available

Job Title:  Health Insurance Specialist, GS-0107-9/11
Department:  Department Of Health And Human Services
Agency:  Centers for Medicare & Medicaid Services
Job Announcement Number:  HHS-CMS-DE-13-820801

This position is closed and no longer accepting online applications through USAJOBS.

The contents of the announcement can still be viewed.
$51,630.00 to $81,204.00 / Per Year
Friday, February 08, 2013 to Wednesday, February 13, 2013
Full Time - Permanent
3 vacancies in the following location:
Washington DC, DC United StatesView Map
United States Citizens


Become a part of the Department that touches the lives of every American! At the Department of Health and Human Services (HHS) you can give back to your community, state, and country by making a difference in the lives of Americans everywhere. It is the principal agency for protecting the health of citizens. Join HHS and help to make our world healthier, safer, and better for all Americans.

The Centers for Medicare and Medicaid Services (CMS) works in partnership with the entire health care community to improve quality and efficiency in an evolving health care system and provides leadership in the broader health care marketplace. Our effectiveness depends on the capabilities of a dedicated, professional staff that is committed to supporting these objectives. A career with CMS offers the opportunity to get involved on important national health care issues and be part of a dynamic, fast-paced, and highly visible organization.  For more information on CMS, please see: 

Additional selections may be made from this announcement for similar positions within CMS in the same geographical location.




  • You must be a U.S. citizen or national to apply for this position.
  • Suitability for Federal employment determined by background investigation.
  • May be required to serve a one-year probationary period.
  • You must meet the Selective Service requirements, if applicable.
  • All supporting documents must be received by the closing date.


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As a Health Insurance Specialist in the Center for Medicare Management, Chronic Care Policy Group, Division of Technical Payment Policy, you will be responsible for:

  • Developing and evaluating Medicare payment policies;
  • Analyzing the effectiveness of program policies and the impact of proposed policy changes or new regulations on existing program operations;
  • Drafting advisory opinions, briefing and issue papers, regulatory drafts, guidance issuances, manuals, and other documents for use by various audiences; and
  • Establishing and maintaining relationships with regional offices, State and local officials, and other key stakeholders to interpret policies, provide guidance, or resolve problems.


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In order to be qualified for this position at the GS-09 level, you must possess one of the following:

A. At least one year of specialized experience, equivalent to the GS-07 level in the Federal service, that included assisting in the review of data to evaluate the impact of new or revised policies or regulations on existing programs; drafting briefing or issue papers analyzing Federal or State policies or regulations; and maintaining positive working relationships with key stakeholder groups to accomplish organizational objectives -OR-

B. A master's or equivalent graduate degree or two full years of progressively higher level graduate education leading to such a degree or LL.B. or J.D., if related; or a combination of the required experience and education for this grade level. -OR-

C. A combination of specialized experience as described in A and graduate education as described in B that, when combined, equals 100% of the total requirement.


In order to be qualified for this position at the GS-11 level, you must possess one of the following:


A. At least one year of specialized experience, equivalent to the GS-09 level in the Federal service, that included applying established qualitative and quantitative techniques to analyze the effectiveness or efficiency of programs or policies; evaluating the impact of new or revised policies or regulations on existing programs; and drafting a variety of policy, regulatory, or legislative documents which summarize changes to policies or programs.; -OR-

B. A Ph.D. or equivalent doctoral degree or three full years of progressively higher level graduate education leading to such a degree or LL.M., if related; or a combination of the required experience and education for this grade level.  -OR-

C. A combination of specialized experience as described in A and graduate education as described in B that, when combined, equals 100% of the total requirement. (Please note that only graduate education in excess of the first two years may be used this calculation.)


If you are claiming education as any part of your qualifications for this position, you must submit an official transcript, unofficial transcript, or a list including courses, grades earned, completion dates, and quarter and semester hours earned.   Failure to do so may result in an ineligible rating.

Foreign Education:  If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show that the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program.  For further information, click on foreign education


Conditions of Employment:


1. Security and Background Requirements: If not previously completed, a background security investigation will be required for all appointees.  Appointment will be subject to the applicant's successful completion of a background security investigation and favorable adjudication.  Failure to successfully meet these requirements may be grounds for appropriate personnel action.  In addition, if hired, a background security reinvestigation or supplemental investigation may be required at a later time.  Applicants are also advised that all information concerning qualifications is subject to investigation.  False representation may be grounds for non-consideration, non-selection and/or appropriate disciplinary action. 

·    Optional Form 306 – Declaration of Federal Employment – available at This form is not required to be submitted at the time of submitting your application. However, if selected, this form will be required prior to final job offer.


2. E-Verify: If you are selected for this position, the documentation that you present for purposes of completing the Department of Homeland Security (DHS) Form I-9 will be verified through the DHS "E-Verify" System.  Federal law requires DHS to use the E-Verify System to verify employment eligibility of all new hires, and as a condition of continued employment obligates the new hire to take affirmative steps to resolve any discrepancies identified by the system.  The U.S. Department of Health and Human Services is an E-Verify Participant.


3. Direct Deposit: All Federal employees are required to have Federal salary payments made by direct deposit to a financial institution of their choosing. 

4. All qualification requirements must be met within 30 days after the closing date of the announcement. 

5. Financial disclosure statement may be required. 

6. One-year probationary period may be required.

7. Travel, transportation, and relocation expenses will be paid:  No

8. Bargaining Unit Position: Yes  

9. Drug Screening Required: Yes or No

10. Recruitment incentives may be authorized: No

11. Students loan repayment incentive authorized: No

12. Annual leave for non-federal service authorized: No


Once the application process is complete, a review of the best-qualified applications will be conducted.  The résumé and supporting documentation will be compared against the applicant's responses to the assessment questionnaire to determine if the applicant is qualified for this job. If, after reviewing the applicant's résumé and supporting documentation, a determination is made that the applicant has inflated his/her qualifications and/or experience, the applicant may lose consideration for this position and/or the applicant's score may be adjusted to more accurately reflect his/her skills and abilities.  Please follow all instructions carefully. Errors or omissions may affect your eligibility.


For Competitive Applicants/All U.S. Citizens:  Eligible candidates will be assigned to a quality category: Best Qualified, Well Qualified or Qualified.  Candidates in the highest category will be referred to the hiring agency.  Please note that applicants with veterans preference in the highest category have selection rights over applicants without veterans preference.  Applicants with veterans preference may be referred on a veterans-only certificate to the selecting official ahead of non-veterans for consideration and selection.

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

Your qualifications will be evaluated against the following competencies (knowledge, skills, abilities, and other characteristics):

·    Technical Knowledge - Medicare          

·    Planning and Evaluating       

·    Written Communication      


To preview the assessment questionnaire, click the following link: View Occupational Questionnaire 


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The Federal government offers a comprehensive benefits package.  Explore the major benefits offered to most Federal employees at


Veterans' Preference: If you are a veteran claiming 5-point veterans' preference, you must submit a copy of your DD-214 (Member Copy 4) or an official statement (including Character of Service) from your command if currently on active duty. If you are claiming 10-point veterans' preference, in addition to the DD-214, you must also submit a Standard Form 15 (Application for 10-Point Veteran Preference) and the required supporting documents listed on that form.  For more information on veterans' preference see .

Career Transition Assistance Programs: This program applies to Federal workers whose positions have been deemed 'surplus' or no longer needed, or an employee has been involuntarily separated from a Federal service position within the competitive service.  To receive selection priority for this position, you must be rated 'well-qualified'.  For information on how to apply and what documents to submit as an CTAP/ICTAP eligible, go to:  Candidates must meet or exceed the Well-Qualified category (85) to be considered as an ICTAP eligible.

Selective Service: The Defense Authorization Act of 1986 requires that all male applicants born after 12/31/59 who are required to register under the Military Selective Service Act, be registered or they are not eligible for appointment to this position.  For further information concerning Selective Service requirements, please visit


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Click the Apply Online button to create an account or log in to your existing USAJOBS account.  Follow the prompts to complete the on-line assessment questionnaire. Please ensure you click the Submit My Answers button at the end of the process.

Note: To return to your saved application materials, log in at: and click on Vacancy ID 820801.

If you cannot apply online, you will need to:


1) Print the instructions and questionnaire by clicking View Occupational Questionnaire.

2) Print the 1203FX form to record your responses to the questionnaire.

3) Fax the completed 1203FX (all 6 pages but do not include a Cover Page for this document) to:  1-478-757-3144.

4) Print the  Fax Cover Page and include with any supporting documents you fax (e.g., résumé, transcripts, veterans documentation, etc.) to the same fax number above.


Please do not complete steps 1-4 above if you are applying on-line.


·     Your Resume - If you use your own resume, curriculum vitae, or any other written form you choose then you must describe your job-related qualifications that include beginning and ending dates for paid and non-paid work experience, hours worked per week, month and year of employment for each job title listed.


·     Responses to the Assessment Questionnaire


Other Supporting Documents: (Only submit if applicable to you.)


·     College transcripts (if qualifying all or in part based on your education)

·     Veterans' Preference documentation (Copy of DD-214 provided must show type of discharge/character of service

·     CTAP/ICTAP documentation




For Resume and Application Tips visit:


Philadelphia Services Branch
Phone: (215)861-3074
Agency Information:
US Office of Personnel Management
600 Arch Street
Philadelphia, PA


Once the online questionnaire is received you will receive an acknowledgement email that your submission was successful.  The most highly qualified candidates will be referred to the hiring manager for further consideration and possible interview.  We expect to make a selection within 45 days of the closing date of this announcement.  You will receive notice via email or by mail (if no email address was provided by you during the application process) once this process is completed (generally 4 - 6 weeks).

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