This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Office of Financial Management, Payment Accuracy and Report Group, Division of Comprehensive Error Rate Testing .
As a Nurse (Program Vulnerability Detection & Prevention), GS-0610-11/12, you will provide clinical guidance as part of CMS program policy or support teams, responsible for interpreting applicable laws, regulations, and policies for CMS insurance programs.
Summary
This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Office of Financial Management, Payment Accuracy and Report Group, Division of Comprehensive Error Rate Testing .
As a Nurse (Program Vulnerability Detection & Prevention), GS-0610-11/12, you will provide clinical guidance as part of CMS program policy or support teams, responsible for interpreting applicable laws, regulations, and policies for CMS insurance programs.
Identify trends and problem areas and recommends needed revisions to existing program policies, criteria, standards, and procedures.
Coordinate with stakeholders to develop solutions to program problems.
Work with CMS components on data interpretation, recovery audits, claims processing and payment, medical review, and appeals to ensure accurate implementation of clinical healthcare policy.
Track effectiveness of corrective actions to identify, monitor, and mitigate program vulnerabilities and reduce improper payments.
You must be a U.S. Citizen or National to apply for this position.
You will be subject to a background and suitability investigation.
This is a remote position; however, the position reports to a CMS Office on a periodic basis. Requirements to report to the office will vary and can be discussed at the time of interview.
Qualifications
ALL QUALIFICATION REQUIREMENTS MUST BE MET BY THE CLOSING DATE OF THIS ANNOUNCEMENT.
Your resume 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 receiving further consideration.
Licensure:For all grade levels for this position, you must have passed the National Council Licensure Examination (external link). In addition, you must possess a current, active, full, and unrestricted license or registration as a professional nurse from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States. Proof of license/registration MUST be submitted at the time of application. Failure to submit proof of license/registration at the time of application WILL result in an ineligible rating.
Basic Requirement for the GS-11 Grade Level:In addition to the mandatory education and licensurerequirements listed above, you must meet one of the following:
In order to qualify for the GS-11, 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-09 grade level in the Federal government, obtained in either the private or public sector), to include: Assisting in identifying program vulnerabilities that impact medical/nursing elements of the healthcare delivery system; AND possession of a diploma, associate degree, bachelor's degree, or master's degree from a professional nursing educational program. -OR-
Possess a Ph.D. or equivalent doctoral degree from a professional nursing educational program or related medical science field. (TRANSCRIPT REQUIRED AT TIME OF APPLICATION)
TRANSCRIPTS are required to verify satisfactory completion of the educational requirement related to substitution of education for experience and combination of experience and education. Please see "Required Documents" section below for what documentation is required at the time of application.
Basic Requirement for the GS-12 Grade Level:In addition to the mandatory education and licensurerequirements listed above, you must meet the following:
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: Identifying program vulnerabilities that impact medical/nursing elements of the healthcare delivery system; AND possession of a diploma, associate degree, bachelor's degree, or master's degree from a professional nursing educational program.
Substitution of Education for Experience: There is no substitution of education to meet the specialized experience requirement at the GS-12 grade level.
Combination of Experience and Education: There is no combination of experience and education to meet the specialized experience requirement at the GS-12 grade level.
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.
Education
You are strongly encouraged to submit a copy of your transcripts at the time of application. Unofficial transcripts will be accepted at the time of application. Official transcripts will be required from all selectees prior to receiving an official offer.
License/Registration Requirement: In addition to meeting the qualification requirements, all candidates must possess the license/registration listed below. Proof of license/registration MUST be submitted at the time of application. Failure to submit proof of license/registration at the time of application WILL result in an ineligible rating.
Proof of License/Registration is required at the time of application to verify possession of the license/registration listed above. Failure to submit proof of license/registration at the time of application WILL result in an ineligible rating. Please see the "Required Documents" section below for more information.
Bargaining Unit Position: Yes-American Federation of Government Employees, Local 1923 Tour of Duty: Flexible Recruitment/Relocation Incentive: Not Authorized Financial Disclosure: Not Required
To ensure compliance with an applicable preliminary nationwide injunction, which may be supplemented, modified, or vacated, depending on the course of ongoing litigation, the Federal Government will take no action to implement or enforce Executive Order 14043 Requiring Coronavirus Disease 2019 Vaccination for Federal Employees. Therefore, to the extent a federal job announcement includes the requirement to be fully vaccinated against COVID-19 pursuant to Executive Order 14043, that requirement does not currently apply. Positions with vaccination requirements under authority(ies) separate and distinct from Executive Order 14043 will be clearly identified. HHS may continue to require documentation of proof of vaccination to ensure compliance with those policies. Health and safety protocols remain in effect, in accordance with CDC guidance and the Safer Federal Workforce Task force. Consistent with current guidance, workplace safety protocols will no longer vary based on vaccination status or otherwise depend on the availability of vaccination information. Therefore, to the extent a job announcement states that HHS may request information regarding the vaccination status of selected applicants for the purposes of implementing workplace safety protocols, this statement does not currently apply.
Remote-Out Positions at CMS: This is a remote position; however, the position reports to a CMS Office on a periodic basis (e.g. 1-2 times per year). Requirements to report to the office will vary and can be discussed at the time of interview. As such, your pay will be based on your home address. For more information on locality and pay scales, please click here. Your worksite must be within the United States and you must adhere to all regulations and policies regarding remote work at CMS and in the federal government, including the signing of a remote work agreement.
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.
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.
Traditional rating and ranking of applications does not apply to this vacancy. Applications will be evaluated against the basic qualifications. Qualified candidates will be referred for consideration in accordance with the Office of Personnel Management direct hire guidelines. Veterans' Preference does not apply to direct hire recruitment procedures. Selections made under this vacancy announcement will be processed as new appointments to the civil service. Current civil service employees would, therefore, be given new appointments to the civil service; however, benefits, time served and all other Federal entitlements would remain the same.
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.
1. Resumeshowing relevant experience; cover letter optional. Your resume must indicate your citizenship and if you are registered for Selective Service if you are a male born after 12/31/59. Your resume must also list your work experience and education (if applicable) including the start and end dates (mm/yyyy) of each employment along with the number of hours worked per week. For work in the Federal service, you must include the series and grade level for the position(s). Your resume will be used to validate your responses to the assessment tool(s). For resume and application tips visit: https://www.usajobs.gov/Help/faq/application/documents/resume/what-to-include/
2. CMS Required Documents (e.g., SF-50, DD-214, SF-15, etc.). Required documents may be necessary to be considered for this vacancy announcement. Click here for a detailed description of the required documents. Failure to provide the required documentation WILL result in an ineligible rating OR non-consideration.
3. College Transcripts. If you are substituting college credit in whole, or in part, for experience at specified grades, you must submit a copy of your transcripts at the time of application in order to substitute your education for the required experience. If you do not submit a transcript, your education will not be considered in determining your qualifications for the position. You may submit an unofficial transcript or a list of college courses completed indicating course title, credit hours, and grades received. An official transcript is required if you are selected for the position.
College Transcripts and Foreign Education: Applicants who have completed part or all of their education outside of the U.S. must have their foreign education evaluated by an accredited organization to ensure that the foreign education is comparable to education received in accredited educational institutions in the U.S. For a listing of services that can perform this evaluation, visit the National Association of Credential Evaluation Services website. This list, which may not be all inclusive, is for informational purposes only and does not imply any endorsement of any specific agency.
4. License/Registration. Since this position requires specific license/registration, you MUST submit a copy of your valid and active license/registration at the time of application attesting to your possession of the required license/registration. Failure to submit proof of license/registration at the time of application WILL result in an ineligible rating.
PLEASE NOTE: A complete application package includes the online application, resume, transcripts, license/registration and CMS required documents. Please carefully review the full job announcement to include the "Required Documents" and "How to Apply" sections. Failure to submit the online application, resume, transcripts and CMS required documents, will result in you not being considered for employment.
Additional Forms REQUIRED Prior to Appointment:
Optional Form 306, Declaration of Federal Employment and the Background/Suitability Investigation - A background and suitability investigation will be required for all selectees. Appointment will be subject to the successful completion of the investigation and favorable adjudication. Failure to successfully meet these requirements may be grounds for appropriate personnel action. In addition, if hired, a reinvestigation or supplemental investigation may be required at a later time. If selected, the Optional Form 306 will be required prior to final job offer. Click here to obtain a copy of the Optional Form 306.
Form I-9, Employment Verification and the Electronic Eligibility Verification Program - CMS participates in the Electronic Employment Eligibility Verification Program (E-Verify). E-Verify helps employers determine employment eligibility of new hires and the validity of their Social Security numbers. If selected, the Form I-9 will be required at the time of in-processing. Click here for more information about E-Verify and to obtain a copy of the Form I-9.
If you are unable to apply online or need to fax a document you do not have in electronic form, view the following link for information regarding an Alternate Application.
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.
Your complete application package, as described in the "Required Documents" section, must be received by 11:59 PM ET on 03/31/2023 to receive consideration.
IN DESCRIBING YOUR WORK EXPERIENCE AND/OR EDUCATION, PLEASE BE CLEAR AND SPECIFIC REGARDING YOUR EXPERIENCE OR EDUCATION.
We strongly encourage applicants to utilize the USAJOBS resume builder in the creation of resumes. Please ensure EACH work history includes ALL of the following information:
Official Position Title (include series and grade if Federal job)
Duties (be specific in describing your duties)
Employer's name and address
Supervisor name and phone number
Start and end dates including month and year (e.g. June 2007 to April 2008)
Full-time or part-time status (include hours worked per week)
Salary
Determining length of general or specialized experience is dependent on the above information and failure to provide ALL of this information WILL result in a finding of ineligible.
To begin, click Apply to access the online application. You will need to be logged into your USAJOBS account to apply. If you do not have a USAJOBS account, you will need to create one before beginning the application.
Follow the prompts to select your resume and/or other supporting documents to be included with your application package. You will have the opportunity to upload additional documents to include in your application before it is submitted. Your uploaded documents may take several hours to clear the virus scan process.
After acknowledging you have reviewed your application package, complete the Include Personal Information section as you deem appropriate and click to continue with the application process.
You will be taken to the online application which you must complete in order to apply for the position. Complete the online application, verify the required documentation is included with your application package, and submit the application.
To verify the status of your application, log into your USAJOBS account (https://my.usajobs.gov/Account/Login), all of your applications will appear on the Welcome screen. 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/.
This agency provides reasonable accommodation to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please send an email to hrinquiries@cms.hhs.gov. The decision to grant reasonable accommodation will be made on a case-by-case basis.
Commissioned Corps Officers (including Commissioned Corps applicants that are professionally boarded) who are interested in applying for this position must send their professional resume (not PHS Curriculum Vitae) and cover letter to CMSCorpsJobs@cms.hhs.gov in lieu of applying through this announcement. The cover letter should specifically explain how you are qualified for this position and draw specific attention to your resume that demonstrates these qualifications. Also send any transcripts, licenses or certifications as requested in this announcement. Please send all documents in 1 PDF file. In the subject line of your e-mail please include only the Job Announcement Number. In the body of your e-mail please include your current rank name and serial number. Failure to provide this information may impact your consideration for this position.
Additional selections may be made for similar positions across the Department of Health and Human Services (HHS) within the local commuting area(s) of the location identified in this announcement. By applying, you agree to have your application shared with interested selecting official(s) at HHS. Clearance of CTAP/ICTAP will be applied for similar positions across HHS.
Office of Financial Management
7500 Security Blvd
Woodlawn, MD 21244
US
Next steps
Once your online application is submitted, you will receive a confirmation notification by email. Within 30 business days of the closing date,03/31/2023, you may check your status online by logging into your USAJOBS account (https://my.usajobs.gov/Account/Login). We will update your status after each key stage in the application process has been completed.
HHS has a critical preparedness and response mission: HHS protects the American people from health threats, researches emerging diseases, and mobilizes public health programs with domestic and international partners. In support of this mission, HHS offers its employees the opportunity to volunteer to become Federal Civilian Detailees and contribute their unique skills through voluntary temporary assignments to humanitarian emergencies or Departmental priorities countering new and emerging health, safety, and security threats.
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
1. Resumeshowing relevant experience; cover letter optional. Your resume must indicate your citizenship and if you are registered for Selective Service if you are a male born after 12/31/59. Your resume must also list your work experience and education (if applicable) including the start and end dates (mm/yyyy) of each employment along with the number of hours worked per week. For work in the Federal service, you must include the series and grade level for the position(s). Your resume will be used to validate your responses to the assessment tool(s). For resume and application tips visit: https://www.usajobs.gov/Help/faq/application/documents/resume/what-to-include/
2. CMS Required Documents (e.g., SF-50, DD-214, SF-15, etc.). Required documents may be necessary to be considered for this vacancy announcement. Click here for a detailed description of the required documents. Failure to provide the required documentation WILL result in an ineligible rating OR non-consideration.
3. College Transcripts. If you are substituting college credit in whole, or in part, for experience at specified grades, you must submit a copy of your transcripts at the time of application in order to substitute your education for the required experience. If you do not submit a transcript, your education will not be considered in determining your qualifications for the position. You may submit an unofficial transcript or a list of college courses completed indicating course title, credit hours, and grades received. An official transcript is required if you are selected for the position.
College Transcripts and Foreign Education: Applicants who have completed part or all of their education outside of the U.S. must have their foreign education evaluated by an accredited organization to ensure that the foreign education is comparable to education received in accredited educational institutions in the U.S. For a listing of services that can perform this evaluation, visit the National Association of Credential Evaluation Services website. This list, which may not be all inclusive, is for informational purposes only and does not imply any endorsement of any specific agency.
4. License/Registration. Since this position requires specific license/registration, you MUST submit a copy of your valid and active license/registration at the time of application attesting to your possession of the required license/registration. Failure to submit proof of license/registration at the time of application WILL result in an ineligible rating.
PLEASE NOTE: A complete application package includes the online application, resume, transcripts, license/registration and CMS required documents. Please carefully review the full job announcement to include the "Required Documents" and "How to Apply" sections. Failure to submit the online application, resume, transcripts and CMS required documents, will result in you not being considered for employment.
Additional Forms REQUIRED Prior to Appointment:
Optional Form 306, Declaration of Federal Employment and the Background/Suitability Investigation - A background and suitability investigation will be required for all selectees. Appointment will be subject to the successful completion of the investigation and favorable adjudication. Failure to successfully meet these requirements may be grounds for appropriate personnel action. In addition, if hired, a reinvestigation or supplemental investigation may be required at a later time. If selected, the Optional Form 306 will be required prior to final job offer. Click here to obtain a copy of the Optional Form 306.
Form I-9, Employment Verification and the Electronic Eligibility Verification Program - CMS participates in the Electronic Employment Eligibility Verification Program (E-Verify). E-Verify helps employers determine employment eligibility of new hires and the validity of their Social Security numbers. If selected, the Form I-9 will be required at the time of in-processing. Click here for more information about E-Verify and to obtain a copy of the Form I-9.
If you are unable to apply online or need to fax a document you do not have in electronic form, view the following link for information regarding an Alternate Application.
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.
Your complete application package, as described in the "Required Documents" section, must be received by 11:59 PM ET on 03/31/2023 to receive consideration.
IN DESCRIBING YOUR WORK EXPERIENCE AND/OR EDUCATION, PLEASE BE CLEAR AND SPECIFIC REGARDING YOUR EXPERIENCE OR EDUCATION.
We strongly encourage applicants to utilize the USAJOBS resume builder in the creation of resumes. Please ensure EACH work history includes ALL of the following information:
Official Position Title (include series and grade if Federal job)
Duties (be specific in describing your duties)
Employer's name and address
Supervisor name and phone number
Start and end dates including month and year (e.g. June 2007 to April 2008)
Full-time or part-time status (include hours worked per week)
Salary
Determining length of general or specialized experience is dependent on the above information and failure to provide ALL of this information WILL result in a finding of ineligible.
To begin, click Apply to access the online application. You will need to be logged into your USAJOBS account to apply. If you do not have a USAJOBS account, you will need to create one before beginning the application.
Follow the prompts to select your resume and/or other supporting documents to be included with your application package. You will have the opportunity to upload additional documents to include in your application before it is submitted. Your uploaded documents may take several hours to clear the virus scan process.
After acknowledging you have reviewed your application package, complete the Include Personal Information section as you deem appropriate and click to continue with the application process.
You will be taken to the online application which you must complete in order to apply for the position. Complete the online application, verify the required documentation is included with your application package, and submit the application.
To verify the status of your application, log into your USAJOBS account (https://my.usajobs.gov/Account/Login), all of your applications will appear on the Welcome screen. 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/.
This agency provides reasonable accommodation to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please send an email to hrinquiries@cms.hhs.gov. The decision to grant reasonable accommodation will be made on a case-by-case basis.
Commissioned Corps Officers (including Commissioned Corps applicants that are professionally boarded) who are interested in applying for this position must send their professional resume (not PHS Curriculum Vitae) and cover letter to CMSCorpsJobs@cms.hhs.gov in lieu of applying through this announcement. The cover letter should specifically explain how you are qualified for this position and draw specific attention to your resume that demonstrates these qualifications. Also send any transcripts, licenses or certifications as requested in this announcement. Please send all documents in 1 PDF file. In the subject line of your e-mail please include only the Job Announcement Number. In the body of your e-mail please include your current rank name and serial number. Failure to provide this information may impact your consideration for this position.
Additional selections may be made for similar positions across the Department of Health and Human Services (HHS) within the local commuting area(s) of the location identified in this announcement. By applying, you agree to have your application shared with interested selecting official(s) at HHS. Clearance of CTAP/ICTAP will be applied for similar positions across HHS.
Office of Financial Management
7500 Security Blvd
Woodlawn, MD 21244
US
Next steps
Once your online application is submitted, you will receive a confirmation notification by email. Within 30 business days of the closing date,03/31/2023, you may check your status online by logging into your USAJOBS account (https://my.usajobs.gov/Account/Login). We will update your status after each key stage in the application process has been completed.
HHS has a critical preparedness and response mission: HHS protects the American people from health threats, researches emerging diseases, and mobilizes public health programs with domestic and international partners. In support of this mission, HHS offers its employees the opportunity to volunteer to become Federal Civilian Detailees and contribute their unique skills through voluntary temporary assignments to humanitarian emergencies or Departmental priorities countering new and emerging health, safety, and security threats.
Fair and transparent
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
