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Health Insurance Specialist

Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Medicaid and Children's Health Insurance Program (CHIP) Services (CMCS)
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 Medicaid and CHIP Services CMCS, Managed Care Group (MCG).

As a Health Insurance Specialist, GS-0107-14, you will serve as a technical authority and technical advisor in the development and implementation of Medicaid Managed Care policies and related
initiatives.

Overview

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Hiring complete
Open & closing dates
07/07/2023 to 07/13/2023
Salary
$99,908 to - $129,878 per year

This is BASE salary for the position. Please see "Additional Information" for locality pay rates.

Pay scale & grade
GS 14
Location
few vacancies in the following location:
Anywhere in the U.S. (remote job)
Remote job
Yes - This is a remote position; however, the position reports to Woodlawn, Maryland on a periodic basis.
Telework eligible
Not applicable, this is a remote position.
Travel Required
Occasional travel - You may be expected to travel for this position. This position has a requirement for up to 5%.
Relocation expenses reimbursed
No
Appointment type
Temporary promotion - NTE 1 year
Work schedule
Full-time
Service
Competitive
Promotion potential
14
Supervisory status
No
Security clearance
Not Required
Drug test
No
Position sensitivity and risk
High Risk (HR)
Trust determination process
Announcement number
CMS-CMCS-23-12034294-IMP
Control number
735651800

This job is open to

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Clarification from the agency

Career Transition Assistance Plan Eligibles; OR Current Permanent Career and Career-Conditional Employees in CMS, Center for Medicaid and Children's Health Insurance Program (CHIP) Services (CMCS).

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Duties

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  • Serve as a technical authority and program expert on Medicaid Managed Care.
  • Conduct or evaluate the review of State Medicaid health policy and programs.
  • Lead projects or studies that analyze the efficiency, effectiveness and/or outcomes of the Medicaid Managed Care programs.
  • Consult and advise management on critical policies, procedures, and issues that have a major impact on CMCS programs.
  • Provide expert and authoritative advice and guidance in the evaluation of proposed, modified or critical new legislation and regulations to assess Impact on Medicaid Managed Care.

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.
  • Time-in-Grade restrictions apply.

Qualifications

ALL QUALIFICATION REQUIREMENTS MUST BE MET WITHIN 30 DAYS OF 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-14 , 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:

  • Providing technical guidance on Medicaid Managed Care policies or initiatives; AND
  • Drafting or editing health policy statements, guidelines, or procedural instructions to implement health care initiatives; AND
  • Collaborating and negotiating with various stakeholders for policy development, implementation, or program improvement.
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.

Time-in-Grade: To be eligible, current Federal employees must have served at least 52 weeks (one year) at the next lower grade level from the position/grade level(s) to which they are applying.

Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/12034294

Education

This job does not have an education qualification requirement.

Additional information

Bargaining Unit Position: Yes-American Federation of Government Employees, Local 1923
Tour of Duty: Flexible
Recruitment/Relocation Incentive: Not Authorized
Financial Disclosure: Yes

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.

How you will be evaluated

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

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
  • Project Management
  • Reasoning


This position is being filled through a temporary promotion that may not exceed one year. In rare instances, an extension may be granted beyond one year. Management may end this temporary promotion at any time, and in such cases, the employee will be returned to the previously held position or another position of equivalent grade and pay. In addition, this temporary promotion may be made permanent at any time without further competition.

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