This position is located in the Performance Improvement Group (PI) within OPM's Federal Employee Insurance Operations, Healthcare and Insurance (HI). The incumbent supports the end-to-end operation of the Plan Performance Assessment (PPA) through which FEHB Carriers profit factor is determined. This can include measure curation, score calculation and verification, complex analysis, measure and methodology maintenance, results reporting, data visualization, trend analysis, and related activities
Summary
This position is located in the Performance Improvement Group (PI) within OPM's Federal Employee Insurance Operations, Healthcare and Insurance (HI). The incumbent supports the end-to-end operation of the Plan Performance Assessment (PPA) through which FEHB Carriers profit factor is determined. This can include measure curation, score calculation and verification, complex analysis, measure and methodology maintenance, results reporting, data visualization, trend analysis, and related activities
- Recommend new measures for selection, and maintenance of measures evaluated in the PPA, including: identifying new measures, measure updates and retirements, weighting, scoring and analysis of results across the portfolio of FEHB and FEDVIP plans.
- Participating in conducting annual plan review for all FEHB carriers to validate or dispute scoring before final results are applied to allowable plan payment formulas.
- Participating in monitoring the PPA to detect vulnerabilities in the measure set or methodology, as well as individual and systematic elements of noncompliance by carriers.
- Drafting and compiling internal and external program documents, including but not limited to PPA Carrier Letters, Operations Manuals, Methodology Manual, reports, white papers, and trend analyses, as well as accreditation programs and patient safety.
- Identifying and preparing presentations and training modules for FEHB Carriers and HI staff.
- Developing and executing internal audit, reconciliation, and controls.
- Outlining internal and external communication of program goals, policy initiatives, and accomplishments on QCR performance areas.
- Elucidating and communicating best practices through PPA data analysis, literature review, or market research.
- Overseeing proper administration of contracts and vendor relationships supporting PPA, including procurement, contractor evaluation, and exercising options.
- Managing the production and approval of PPA content for the OPM website, FEHB brochures, and applicable consumer choice tools supporting Open Season.
- Providing subject matter expertise on quality, customer service, resource use, and business metrics as well as accreditation programs.
- Identify, describe, build the business case for, and recommend needed program revisions.
- Interact with FEHB Contracting Officers and actuarial staff to apply PPA scoring to final determination of applicable service charge (experience rated plans) or performance adjustment (community rated plans).
- Interact with all groups and divisions within Healthcare and Insurance as related performance improvement projects are prioritized by PI and HI leadership.
- Assessing new developments and best practices in quality management, performance improvement, and accreditation
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
For the GS 13 Grade Level: Applicants must have one year of specialized experience equivalent to the GS-12 Federal grade level. This experience must have been directly related to timely, efficient, precise, and effective performance accountability for health plan quality, and includes the following:
- Participation in the development of performance assessments, measure specifications, or methodology for a healthcare performance improvement program as indicated by prior positions at a health plan, health system, healthcare quality organization, or government agency performing related work.
- Participation in the evaluation of program quality, customer service, and resource use/cost in any healthcare, insurance, or business setting.
For the GS 14 Grade Level: Applicants must have one year of specialized experience equivalent to the GS-13 Federal grade level. This experience must have been directly related to timely, efficient, precise, and effective performance accountability for health plan quality, and includes the following:
- Development of performance assessments, measure specifications, or methodology for a healthcare performance improvement program as indicated by prior positions at a health plan, health system, healthcare quality organization, or government agency performing related work.
- Evaluation of program quality, customer service, and resource use/cost in any healthcare, insurance, or business setting.
You must meet all qualification and eligibility requirements by the closing date of this announcement.
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.
Quality Ranking Factor: Minimum of two years' experience with a healthcare purchaser, payor, and/or healthcare quality organization/measure developer/measure steward, in planning, development, implementation, and execution of a healthcare quality/ performance improvement program. This can be evidenced by relevant prior positions and/or certification as a health care quality professional (Certified Professional in Healthcare Quality, Certified Professional in Healthcare Risk Management, Certified Utilization Management/Credentialing Review, or similar).
Additional information
Relocation expenses will not be paid. Current OPM employees may qualify as an exception.
Reasonable Accommodation Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended and Americans with Disabilities Act 1990 as amended, that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a reasonable accommodation in your online application. Requests for Reasonable Accommodations for the USA Hire Competency Based Assessments and appropriate supporting documentation for Reasonable Accommodation must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for Reasonable Accommodations 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. 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 Reasonable Accommodation, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments here: https://help.usastaffing.gov/Apply/index.php?title=Reasonable_Accommodations_for_USA_Hire
This job opportunity announcement may be used to fill additional similar vacancies across OPM.
If you are a veteran and you are claiming 5-point veterans' preference, you must submit a copy of your DD-214 or other proof of eligibility. If you are a veteran and you are claiming 10-point veterans' preference, you must also submit an SF-15, "Application for 10-Point Veterans' Preference" plus the proof required by that form. For more information on veterans' preference click here.
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.
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.
For Category Rating: Once the application process is complete, a review of your resume and supporting documentation will be made and compared against your responses to the assessment questionnaire to determine if you are qualified for this job. If, after reviewing your resume and/or supporting documentation, a determination is made that you have inflated your qualifications and/or experience, you may lose consideration for this position. Please follow all instructions carefully. Errors or omissions may affect your eligibility. Qualified candidates will be assigned to one of the three quality categories: Qualified, Well Qualified, or Best Qualified. Qualified Category = Does not exceed the basic qualifications requirements described in the "Qualifications" section of this announcement. Well Qualified Category = Meets the basic qualifications requirements described in the "Qualifications" section of this announcement and demonstrates proficiency in the Critical Competencies defined below. (This category must be met to be considered under ICTAP procedures) Best Qualified Category = Meets the basic qualifications requirements described in the "Qualifications" section of this announcement and excels in the Critical Competencies defined below. The category assignment is a measure of the degree in which your background matches the competencies required for this position.
Your qualifications will be evaluated on the following competencies
Accountability
Analytical Skill
Attention to Detail
Communication
Customer Service
Flexibility
Influencing/Negotiating
Integrity/Honesty
Interpersonal Skills
Knowledge of Federal Insurance Benefit Programs
Learning
Quality Ranking Factor
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.
The assessment includes a cut score based on the minimum level of required proficiency in these critical general competencies. You must meet or exceed the cut score to be considered. You will not be considered for the position if you score below the cut score or fail to complete the assessment.
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 category. Preference eligibles who meet the minimum qualification requirements and have a compensable service-connected disability of at least 10 percent or higher will be listed in the highest quality category (except in the case of scientific or professional positions at the GS-09 level or higher).
Career Transition Assistance Programs: These programs apply to employees who have been involuntarily separated from a Federal service position within the competitive service or Federal service employees whose positions have been deemed surplus or no longer needed. To receive selection priority for this position, you must: 1) meet CTAP or ICTAP eligibility criteria; 2) be rated well-qualified for the position with a score of 80 or above based on the competencies listed above; and 3) submit the appropriate documentation to support your CTAP or ICTAP eligibility. For more information visit: http://www.opm.gov/rif/employee_guides/career_transition.asp.
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.
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.
To apply for this position, you must provide a complete Application Package which includes:
Your Resume showing work schedule, hours worked per week, dates of employment and duties performed.
Other supporting documents:
Cover Letter, optional
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.
Veterans' Preference documentation, if applicable (e.g. DD-214 Member Copy 4 showing type of discharge/character of service; Current Active Duty members must submit a certification of expected discharge or release from active duty under honorable conditions dated within 120 days; SF-15 Form and related documentation; VA letter.)
Career Transition Assistance Program/Interagency Career Transition Assistance Program documentation, if applicable (e.g. Certification of Expected Separation, Reduction-In-Force Separation Notice, or Notice of Proposed Removal; SF-50 that documents the RIF separation action; and most recent performance appraisal.)
Worker's Compensation Separation: Agency certification of inability to place employee AND Notification of Separation OR Separation SF-50.
Disability Annuity Termination: Notification from OPM of disability annuity termination AND Separation SF-50 of the last position held.
Military Reserve or National Guard Technician Special Disability Retirement Annuity under 5 U.S.C. 8337(h) or 8456: Certification of special disability retirement annuity from a military department or National Guard Bureau AND Separation SF-50 of the last position held
Failure to submit any of the above mentioned required documents may result in loss of consideration due to an incomplete application package. It is your responsibility to ensure all required documents have been submitted.
If you are relying on your education to meet qualification requirements:
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
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 (EST)on 02/05/2021 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 11:59pm (ET) on the announcement closing date.
After submitting an online application, you will be notified whether or not you are required to take additional online assessments through the USA Hire Competency Based Assessments system. This message will be delivered to you both on screen and via email notification.
If you are asked to take the USA Hire Competency Based Assessments, you will be presented with a unique URL to access the USA Hire system. Access to USA Hire is granted through your USAJOBS login credentials. Be sure to review all instructions prior to beginning your USA Hire Assessments. Note, set aside at least 3 hours to take these assessments; however, most applicants complete the assessments in less time. If you need to stop the assessments and continue at a later time, you can re-use the URL sent to you via email and also found on the "Additional Application Information" page that can be located in the application record in your USAJOBS account.
To update your application, including supporting documentation, at any time during the announcement open period by returning to your USAJOBS account. There you will find a record of your application, the application status, and an option to "Update Application." This option will no longer be available once the announcement has closed.
To verify the status of your application both during and after the announcement open period, log into your USAJOBS account, all of your applications will appear on the Welcome screen. The application record in your USAJOBS account provides an "Additional Application Information" page that provides information regarding the documentation you submitted and any correspondence we have sent related to this application. The Application Status will appear along with the date your application was last updated. For information on what each Application Status means, visit: https://www.usajobs.gov/Help/how-to/application/status/.
OPM Human Resources
1900 E St., NW
Washington, DC 20415
US
Next steps
Based on your application and your responses to the application questionnaire, you may be presented with instructions on how to access the USA Hire system to complete the online assessments. The online assessments must be completed within 48 hours following the close of this announcement. You will have the opportunity to request a testing accommodation for the assessment should you have a disability covered under the Americans with Disabilities Act (ADA). Your assessment results will be kept on record for one year and used toward future positions for which you might apply that require the same assessments. To be considered for the position, you must meet all qualifications, including meeting or exceeding the cut score on the required assessments.
We expect to make a job offer within 40 days after the closing date of the announcement. After making a tentative job offer, we will conduct a suitability/security background investigation.
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
To apply for this position, you must provide a complete Application Package which includes:
Your Resume showing work schedule, hours worked per week, dates of employment and duties performed.
Other supporting documents:
Cover Letter, optional
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.
Veterans' Preference documentation, if applicable (e.g. DD-214 Member Copy 4 showing type of discharge/character of service; Current Active Duty members must submit a certification of expected discharge or release from active duty under honorable conditions dated within 120 days; SF-15 Form and related documentation; VA letter.)
Career Transition Assistance Program/Interagency Career Transition Assistance Program documentation, if applicable (e.g. Certification of Expected Separation, Reduction-In-Force Separation Notice, or Notice of Proposed Removal; SF-50 that documents the RIF separation action; and most recent performance appraisal.)
Worker's Compensation Separation: Agency certification of inability to place employee AND Notification of Separation OR Separation SF-50.
Disability Annuity Termination: Notification from OPM of disability annuity termination AND Separation SF-50 of the last position held.
Military Reserve or National Guard Technician Special Disability Retirement Annuity under 5 U.S.C. 8337(h) or 8456: Certification of special disability retirement annuity from a military department or National Guard Bureau AND Separation SF-50 of the last position held
Failure to submit any of the above mentioned required documents may result in loss of consideration due to an incomplete application package. It is your responsibility to ensure all required documents have been submitted.
If you are relying on your education to meet qualification requirements:
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
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 (EST)on 02/05/2021 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 11:59pm (ET) on the announcement closing date.
After submitting an online application, you will be notified whether or not you are required to take additional online assessments through the USA Hire Competency Based Assessments system. This message will be delivered to you both on screen and via email notification.
If you are asked to take the USA Hire Competency Based Assessments, you will be presented with a unique URL to access the USA Hire system. Access to USA Hire is granted through your USAJOBS login credentials. Be sure to review all instructions prior to beginning your USA Hire Assessments. Note, set aside at least 3 hours to take these assessments; however, most applicants complete the assessments in less time. If you need to stop the assessments and continue at a later time, you can re-use the URL sent to you via email and also found on the "Additional Application Information" page that can be located in the application record in your USAJOBS account.
To update your application, including supporting documentation, at any time during the announcement open period by returning to your USAJOBS account. There you will find a record of your application, the application status, and an option to "Update Application." This option will no longer be available once the announcement has closed.
To verify the status of your application both during and after the announcement open period, log into your USAJOBS account, all of your applications will appear on the Welcome screen. The application record in your USAJOBS account provides an "Additional Application Information" page that provides information regarding the documentation you submitted and any correspondence we have sent related to this application. The Application Status will appear along with the date your application was last updated. For information on what each Application Status means, visit: https://www.usajobs.gov/Help/how-to/application/status/.
OPM Human Resources
1900 E St., NW
Washington, DC 20415
US
Next steps
Based on your application and your responses to the application questionnaire, you may be presented with instructions on how to access the USA Hire system to complete the online assessments. The online assessments must be completed within 48 hours following the close of this announcement. You will have the opportunity to request a testing accommodation for the assessment should you have a disability covered under the Americans with Disabilities Act (ADA). Your assessment results will be kept on record for one year and used toward future positions for which you might apply that require the same assessments. To be considered for the position, you must meet all qualifications, including meeting or exceeding the cut score on the required assessments.
We expect to make a job offer within 40 days after the closing date of the announcement. After making a tentative job offer, we will conduct a suitability/security background investigation.
Fair and transparent
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
