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Health Insurance Specialist (Legal)

Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Medicare and Medicaid Innovation (CMMI)
This job announcement has closed

Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid Innovation, (CMMI), Policy & Program Group (PPG), Division of Alternative Payment Model Infrastructure (DAPMI).

As a Health Insurance Specialist (Legal), GS-0107-13, you will serve as a subject-matter expert analyst for model development and model maintenance with specific focus on legal aspects of models.

Overview

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Reviewing applications
Open & closing dates
12/11/2024 to 12/16/2024
Salary
$117,962 to - $153,354 per year
Pay scale & grade
GS 13
Locations
1 vacancy in the following locations:
Bethesda, MD
Woodlawn, MD
Remote job
No
Telework eligible
Yes—as determined by the agency policy.
Travel Required
Occasional travel - You may be expected to travel 5% for this position
Relocation expenses reimbursed
No
Appointment type
Permanent
Work schedule
Full-time
Service
Competitive
Promotion potential
13
Supervisory status
No
Security clearance
Not Required
Drug test
No
Position sensitivity and risk
Moderate Risk (MR)
Trust determination process
Financial disclosure
No
Bargaining unit status
Yes
Announcement number
CMS-CMMI-25-12633036-DE
Control number
823132400

Videos

Duties

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  • Serves as an expert in interpreting statutes and developing and drafting Federal regulations, model governing documentation such as participation agreements and cooperative agreements, program waivers, general provisions of relevant rulemaking.
  • Serves as expert on legal matters for model team staff to assist and support them toward effectively establishing model designs and policies that are legally sound and operationally feasible.
  • Conducts analyses of legal policy issues and topics in assigned subject areas by researching background information, the origin of laws, and their intended impact to make effective agreements and policy recommendations.
  • Develops and reviews health care legislation, regulations, and policy documents and drafts related policy documents, regulations, procedures, and guidance.
  • Serves as a liaison to CMS’s Office of General Counsel and other internal/external stakeholders regarding legal authorities, procedures, programmatic as well as fraud and abuse waivers, and other related aspects of model design and implementation.

Requirements

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Conditions of employment

  • You must be a U.S. Citizen or National to apply for this position.
  • You will be subject to a background and suitability investigation.

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.


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-13 grade level in the Federal government, obtained in either the private or public sector, to include:

1. Identifying and analyzing legal issues to develop and present solutions;
AND
2. Drafting regulations, program guidance, legislative proposals, waivers, policy memoranda, or binding agreements (e.g. contracts between parties, participation agreements, cooperative agreements, etc.);
AND
3. Reviewing laws, legislative history, court decisions, or policies to propose modifications and making recommendations to programs.

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/12633036

Education

This job does not have an education qualification requirement.

Additional information

Bargaining Unit Position: Yes-American Federation of Government Employees, Local 2268
Tour of Duty: Flexible
Recruitment/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; however, CMS offers flexible working arrangements and allows employees the opportunity to participate in telework combined with alternative work schedules at the manager's discretion. This position may be authorized for telework. Telework eligibility will be discussed during the interview process. Supervisory positions must report a minimum 2 times per week and non-Supervisory positions must report a minimum of 2 times per pay period.

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.

How you will be evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

If you meet the minimum qualifications and education requirements for this position, your application and responses to the online occupational questionnaire will be evaluated under Category Rating and Selection procedures for placement in one of the following categories:

  • Best Qualified - for those who are superior in the evaluation criteria
  • Well Qualified - for those who excel in the evaluation criteria
  • Qualified - for those who only meet the minimum qualification requirements
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. Veterans' preference eligibles who meet the minimum qualification requirements and who have a compensable service-connected disability of at least 10 percent will be listed in the highest quality category (except in the case of professional or scientific positions at the GS-09 level or higher).

Once the announcement has closed, your online application, resume, and CMS required documents will be used to determine if you meet eligibility and qualification requirements listed on this announcement. If you are found to be among the top qualified candidates, you will be referred to the selecting official for employment consideration. Please follow all instructions carefully. Errors or omissions may affect your rating.

Your qualifications will be evaluated on the following competencies (knowledge, skills, abilities and other characteristics):
  • Health Insurance
  • Oral Communication
  • Policy Analysis
  • Written Communication


This is a competitive vacancy announcement advertised under Delegated Examining Authority. 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.

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