As a Health Insurance Specialist (Contracts), you will be part of Healthcare and Insurance (HI), Postal Service Insurance Operations (PSIO). If selected, you will be responsible for ensuring that health insurance carriers participating in the Postal Service Health Benefits Program (PSHBP) are providing the benefits, programs, and services to enrollees as provided for in the annual contract and are operating within OPM and Federal guidelines.
Summary
As a Health Insurance Specialist (Contracts), you will be part of Healthcare and Insurance (HI), Postal Service Insurance Operations (PSIO). If selected, you will be responsible for ensuring that health insurance carriers participating in the Postal Service Health Benefits Program (PSHBP) are providing the benefits, programs, and services to enrollees as provided for in the annual contract and are operating within OPM and Federal guidelines.
This announcement will be used to fill vacancies through the OPM-Direct Hire Authority for the Office of Healthcare and Insurance (OPM-002) due to a Critical Hiring Need/Severe Shortage of Candidates. Veteran preference and traditional rating/ranking of applicants do not apply. For more information on OPM's authorization of Direct Hire Authority, please visit: https://www.opm.gov/policy-data-oversight/hiring-information/direct-hire-authority/
Reviewing and analyzing evidence submitted by health plans applying for participation in the Postal Service Health Benefits Program for compliance with the law, regulations, and office policies and practices.
Monitoring contracts and recommending remediation and maintaining contract files.
Advising carriers on difficult enrollment problems and on changes in the law and regulations and preparing letters to the plans setting forth agency decisions and changes in policy.
Working with carriers to assist them in providing reports and documentation related to their performance in providing services and products to enrollees. Assisting in resolving and documenting actions to resolve any and all negative findings.
Serving independently in the preparation of the health benefits brochures and other Open Season informational materials each calendar year. Ensuring that the plan's brochures and marketing materials comply with the contract.
Planning and conducting post-award conferences to ensure compliance with, and full understanding of, contractual requirements and to preclude unauthorized changes or alterations in contract provisions. Monitoring contractors' performance and solving problems associated with contract disputes.
Maintaining productive working relationships with health plan administrators, union officials and underwriters. Issuing carrier letters and other correspondence as needed in support of the contract.
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
This position is eligible for inclusion in the bargaining unit.
if the duty station is finalized in the Washington, DC metropolitan area, employees in this position will be represented by the American Federation of Government Employees (AFGE) Local 32. (BU Code - 2286)
if the duty station is finalized outside of the Washington, DC metropolitan area, this position will not be represented by a bargaining unit. (BU Code - 7777)
Qualifications
For the GS-12 Grade Level: You must have at least one year of specialized experience which is equivalent in difficulty and complexity to the GS-11 grade level in the Federal Service (obtained in either the private or public sector) which demonstrates at least two of the following activities:
Knowledge of the Federal Acquisition Regulation (FAR), Federal Benefits Acquisition Regulation (FEHBAR), and Federal Employees Health Benefits (FEHB) program policies and/or requirements;
Experience with and knowledge of the health benefits, insurance industry, or fee-for-service or prepaid medical plans;
Performing contract administration including oversight;
Applying knowledge of group health insurance regulations, policies and procedures in the administration of health benefits programs;
Assisting in the development of health insurance contract requirements.
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.
Education
There are no educational requirements for these positions.
Additional information
This announcement will be used to fill vacancies through OPM-authorized Direct Hire Authority due to Critical Hiring Need/Severe Shortage of Candidates. Veteran preference and traditional rating/ranking of applicants do not apply. For more information on OPM's authorization of Direct Hire Authority, please visit: https://www.opm.gov/policy-data-oversight/hiring-information/direct-hire-authority/
Relocation expenses will not be paid.
Incentive payments may be considered.
This job opportunity announcement may be used to fill additional similar vacancies across OPM.
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.
Once the application process is complete, your resume and supporting documentation will be used to determine whether you meet the job qualifications listed on this announcement. Applicants who meet minimum qualification requirements will be certified for further consideration.
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; 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 applicant's name, email address, work schedule, hours worked per week, dates of employment and duties performed.
Other supporting documents:
Cover Letter, optional
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.)
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.
To apply for this position, you must complete the online application and submit the documentation specified in the Required Documents section below.
The complete application package must be submitted by 11:59 PM (EST) on 07/12/2023 to receive consideration.
To begin, click Apply Online to access an online application. Follow the prompts to select your USAJOBS resume and/or other supporting documents. You will need to be logged into your USAJOBS account or you may need to create a new account.
You will be taken to an online application. Complete the online application, verify the required documentation, and submit the application.
You will receive an email notification when your application has been received for the announcement.
To verify the status of your application, log into your USAJOBS account, https://my.usajobs.gov/Account/Login, select the Application Status link and then select the More Information link for this position. The Application Status page will display the status of your application, the documentation received and processed, and your responses submitted to the online application. Your uploaded documents may take several hours to clear the virus scan process.
OPM Human Resources
1900 E St., NW
Washington, DC 20415
US
Next steps
The questionnaire will assess your qualifications for the job, and will be used to identify well qualified ICTAP eligible applicants to be referred to the hiring manager for further consideration and possible interviews. Your ratings in this Assessment Questionnaire are subject to evaluation and verification based on the documents and references you submit. Later steps in the selection process are specifically designed to verify your ratings. Deliberate attempts to falsify information may be grounds for not selecting you or for dismissing you from the position/agency during the probationary period.
Once your online application is submitted you will receive a confirmation notification by email. Your application will be evaluated. You will receive another notification about the status of your application.
Once referred, you may be asked to complete a structured interview, written demonstration, and/or fit interview. Deliberate attempts to falsify information may be grounds for not selecting you or for dismissing you from the position/agency during the probationary period.
Once your online application is submitted you will receive a confirmation notification by email. Your application will be evaluated. You will receive another notification about the status of your application.
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 applicant's name, email address, work schedule, hours worked per week, dates of employment and duties performed.
Other supporting documents:
Cover Letter, optional
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.)
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.
To apply for this position, you must complete the online application and submit the documentation specified in the Required Documents section below.
The complete application package must be submitted by 11:59 PM (EST) on 07/12/2023 to receive consideration.
To begin, click Apply Online to access an online application. Follow the prompts to select your USAJOBS resume and/or other supporting documents. You will need to be logged into your USAJOBS account or you may need to create a new account.
You will be taken to an online application. Complete the online application, verify the required documentation, and submit the application.
You will receive an email notification when your application has been received for the announcement.
To verify the status of your application, log into your USAJOBS account, https://my.usajobs.gov/Account/Login, select the Application Status link and then select the More Information link for this position. The Application Status page will display the status of your application, the documentation received and processed, and your responses submitted to the online application. Your uploaded documents may take several hours to clear the virus scan process.
OPM Human Resources
1900 E St., NW
Washington, DC 20415
US
Next steps
The questionnaire will assess your qualifications for the job, and will be used to identify well qualified ICTAP eligible applicants to be referred to the hiring manager for further consideration and possible interviews. Your ratings in this Assessment Questionnaire are subject to evaluation and verification based on the documents and references you submit. Later steps in the selection process are specifically designed to verify your ratings. Deliberate attempts to falsify information may be grounds for not selecting you or for dismissing you from the position/agency during the probationary period.
Once your online application is submitted you will receive a confirmation notification by email. Your application will be evaluated. You will receive another notification about the status of your application.
Once referred, you may be asked to complete a structured interview, written demonstration, and/or fit interview. Deliberate attempts to falsify information may be grounds for not selecting you or for dismissing you from the position/agency during the probationary period.
Once your online application is submitted you will receive a confirmation notification by email. Your application will be evaluated. You will receive another notification about the status of your application.
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.
