We are looking to fill Health Insurance Specialist, GS-0107-7/9, positions in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS). Click on "Learn more about this agency" for more details!
What is a Health Insurance Specialist (HIS)? At CMS, an HIS can wear many hats. This series typically works within health insurance policy development, research, analysis, and program development.
Summary
We are looking to fill Health Insurance Specialist, GS-0107-7/9, positions in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS). Click on "Learn more about this agency" for more details!
What is a Health Insurance Specialist (HIS)? At CMS, an HIS can wear many hats. This series typically works within health insurance policy development, research, analysis, and program development.
Resolve health insurance program issues by conducting research on the problem area, analyzing the results, and making recommendations to management to resolve any problem areas.
Engage with senior analysts and management in reviewing, analyzing, and developing program documents.
Review, evaluate, and analyze health insurance programs for efficiency and effectiveness.
Review draft regulations and responses to CMS' proposed regulations.
Assist with the administration of health insurance program audits.
You must be a U.S. Citizen or National to apply for this position.
You must possess a cumulative GPA of 3.0 or higher on a 4.0 scale.
You must meet all program, qualification and education requirements.
You will be subject to a background and suitability investigation.
You must sign a Pathways Participant Agreement before starting employment.
Qualifications
PROGRAM REQUIREMENTS: You must be ELIGIBLE and QUALIFIED in order to be referred to Hiring Managers.
ELIGIBILITY REQUIREMENTS:Am I considered a Recent Graduate?
GPA Requirement: You must possess a cumulative GPA of 3.0 on the unweighted 4.0 scale upon completion of your academic degree or certificate program. (GPA 2.95 is rounded to 3.0 and 2.94 is rounded to 2.9.)
To be eligible as a Recent Graduate:
Individuals who within the previous 2 years, completed a qualifying associates, bachelors, masters, professional, doctorate, vocational or technical degree or certificate from a qualifying educational institution. Therefore, you must have completed your educational program no earlier than December 3, 2022. Veterans who were precluded from applying due to their military service obligation, begin their 2-year eligibility period upon release or discharge from active duty. Eligibility for veterans cannot exceed 6 years from the date on which they completed their degrees (or certification). Therefore, veterans must have completed your educational program no earlier than December 3, 2018.
To verify your eligibility as a Recent Graduate, you must submit the following at the time of application: A copy of your unofficial transcripts from the educational institution you attended attesting to your possession of the required education. Your unofficial transcripts must reflect: (1) your name; (2) overall grade point average (GPA); and (3) Degree Type (e.g., Bachelor's, Master's, etc.) and Degree Major; AND (4) the date your Degree was conferred. Failure to submit proof of degree/certificate completion at time of application will result in the withdrawal of your application from consideration for this position.
To be eligible as a Degree Candidate for Fall 2024:
Individuals who are degree candidates for this current semester/term, i.e. Fall 2024, scheduled to complete a qualifying Associate's, Bachelor's, Master's, Doctorate, professional, vocational or technical degree or certificate program AND degree/certificate has not been conferred at time of application.
To verify your eligibility as a Degree Candidate for Fall 2024: you must submit the following at the time of application: A copy of your unofficial transcripts from the educational institution you attended attesting to your education completed to date. Your unofficial transcripts must reflect: (1) your name; (2) overall grade point average (GPA); (3) current enrollment; AND (4) Degree Type (e.g., Bachelor's, Master's, etc.) and Degree Major. If referred and selected, you must submit an additional unofficial transcript that confirms the date your degree was conferred before an Official Offer can be made. Degree must be conferred by January 31, 2025. Failure to submit proof of degree/certificate completion will result in the withdrawal of your application from consideration for this position.
Note: For those applying as Degree Candidates for Fall 2024, you will be required to submit an additional transcript that confirms the above major or course requirements and the date your degree was conferred. Degree requirements must be completed during the Fall 2024 semester and the degree must be conferred by January 31, 2025. Failure to submit proof of degree/certificate completion will result in the withdrawal of your application from consideration for this position.
QUALIFICATION REQUIREMENTS: Do I qualify at the GS-07 or GS-09 Grade Level?
In order to qualify for the GS-07, you must meet one of the following:
Specialized Experience: You must demonstrate in your resume at least one year (52 weeks) of qualifying specialized experience equivalent to the GS-05 grade level in the Federal government, obtained in either the private or public sector, to include: 1) assisting in performing routine analytical studies; and 2) preparing written materials (e.g., position papers, briefing materials, procedures) for senior staff. . - OR -
Substitution of Education for Experience: You may substitute education for specialized experience at the GS-07 grade level by possessing at least one full year of graduate level education. One year of full-time graduate education is considered to be the number of credit hours that the school attended has determined to represent 1 year of full-time study. If that information cannot be obtained from the school, 18 semester hours should be considered as satisfying the 1 year of full-time study requirement. Part-time graduate education is creditable in accordance with its relationship to a year of full-time study at the school attended - OR -
Superior Academic Achievement: A bachelor's degree from an accredited college or university AND one of the following provisions of superior academic achievement:
A grade-point average of "B" (3.0 or higher on a 4.0 scale) for all completed undergraduate courses or those completed in the last two years of undergraduate study. For example, 2.95 is rounded to 3.0, and 2.94 is rounded to 2.9.
A grade-point average of 3.5 or higher on a 4.0 scale for all required courses completed in your major field of study, or those required courses in your major completed in the last two years of your undergraduate study.
Rank in the upper one-third of your class in the college, university, or major subdivision.
Membership in a national honor society (other than freshman honor societies) recognized by the Association of College Honor Societies. - OR -
Combination of Experience and Education: Equivalent combinations of successfully completed post-high school education and experience may be used to meet total experience requirements at the GS-07 grade level. The percentage of your total qualifying experience the education must equal to 100% to qualify for this grade.
In order to qualify for the GS-09, you must meet one of the following:
Specialized Experience: You must demonstrate in your resume at least one year (52 weeks) of qualifying specialized experience equivalent to the GS-07 grade level in the Federal government, obtained in either the private or public sector, to include: 1) performing routine analytical studies related to healthcare programs or policies; and 2) assisting with developing health insurance operational guidance policies, reports, or procedures. - OR -
Substitution of Education for Experience: You may substitute education for specialized experience at the GS-09 grade level by possessing a Master's Degree or equivalent graduate degree or at least 2 full years of progressively higher level graduate education leading to such a degree or LL.B. or J.D. - OR -
Combination of Experience and Education: Only graduate education in excess of the amount required for the GS-07 grade level may be used to qualify applicants for positions at the GS-09 grade level. Therefore, only education in excess of one full year of graduate level education may be used to combine education and experience.
ALL TRANSCRIPTS are requiredat the time of application 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 on what documentation is required.
Click the following link to view the occupational questionnaire:
Education
Qualifications Continued:
NOTE: If you are using specialized experience to qualify for this position, 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.
NOTE: A certificate program is defined as post-secondary education, in a qualifying educational institution, equivalent to at least one academic year of full-time study (30 undergrad credits/18 grad school credits) that is part of an accredited college-level, technical, trade, vocational, or business school curriculum.
Bargaining Unit Position: Yes-American Federation of Government Employees, Local 1923 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.
Conversion Eligibility: Recent Graduates may be eligible for non-competitive conversion to a career, career-conditional, or term appointment after successful completion of the Pathways Recent Graduate program. The position to which converted may have a full-performance level up to a GS-12.
NOTE: Full Performance Level (FPL): Employees selected for this position may be eligible for promotion up to the GS-11 level while in the Pathways Program and up to the GS-12 level after successful completion of the Program. There is no obligation to provide future promotions if you are selected.
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.
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:
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).
You will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics):
Analysis
Health Insurance
Oral Communication
Written Communication
Once the announcement has closed, your online application, resume, transcripts 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.
CMS Pathways - Recent Graduate candidates will meet the qualification requirement consistent with the OPM qualification standards applicable to the position being filled. Veterans' preference applies to selections made under the Pathways authority in accordance with Part 302 of 5 Code of Federal Regulations (CFR). Candidates who meet the eligibility and qualification requirements need not be further evaluated.
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 submit a complete Application Package which includes:
1.Resume showing 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. For work in the Federal service, you must include the series and grade level for the position(s). For resume and application tips visit: https://www.usajobs.gov/Help/faq/application/documents/resume/what-to-include/.
Your resume will be used to validate your responses to the assessment tool(s). We strongly encourage applicants to utilize the USAJOBS resume builder in the creation of resumes. Determining length of general or specialized experience is dependent on the information provided in the resume. Failure to include ALL of the information listed below on your resume WILL result in a finding of ineligible.
- 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 in the month and year format (e.g. June 2007 to April 2008)
- Full-time or part-time status (include hours worked per week)
- Salary
2. CMS Required Documents (e.g., SF-50, DD-214, SF-15, etc.). Supporting documents may be necessary to be considered for this vacancy announcement. Click here for a detailed description of the required supporting documents. Failure to provide the appropriate documentation WILL result in an ineligible rating OR non-consideration.
3. All College Transcripts. Since this position requires specific education, you must submit a transcript attesting to your possession of the required education. You must submit an unofficial transcript at time of application. If you have preceding education, ensure that you submit all transcripts to potentially receive credit. An official transcript is required if you are selected for the position. If selected, you must provide an original document before the final job offer may be extended.
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.
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 must be submitted by 11:59 PM (ET) on 12/03/2024 of the announcement 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)
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 alexis.coby@cms.hhs.gov. The decision to grant reasonable accommodation will be made on a case-by-case basis.
Commissioned Corps Officers (including Commissioned Corps professionally boarded applicants) who are interested in applying for this position must send their cover letter and professional resume (not PHS Curriculum Vitae) to CMSCorpsJobs@cms.hhs.gov in lieu of applying through this announcement. The resume should specifically explain how you are qualified for this position and draw specific attention to your skills and experiences 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 include only the Job Announcement Number. In the body of your e-mail 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 any interested selecting official(s) at HHS. Clearance of CTAP/ICTAP will be applied for similar positions across HHS.
Pathways Recent Graduates Program
7500 Security Blvd
Woodlawn, MD 21244
US
Next steps
Once your online application is submitted, you will receive a confirmation notification by email. Your application will be evaluated to determine your eligibility and qualifications for the position. After the evaluation is complete, you will receive another email notification regarding the status of your application.
Within 30 business days of the closing date, , 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.
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
To apply for this position, you must submit a complete Application Package which includes:
1.Resume showing 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. For work in the Federal service, you must include the series and grade level for the position(s). For resume and application tips visit: https://www.usajobs.gov/Help/faq/application/documents/resume/what-to-include/.
Your resume will be used to validate your responses to the assessment tool(s). We strongly encourage applicants to utilize the USAJOBS resume builder in the creation of resumes. Determining length of general or specialized experience is dependent on the information provided in the resume. Failure to include ALL of the information listed below on your resume WILL result in a finding of ineligible.
- 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 in the month and year format (e.g. June 2007 to April 2008)
- Full-time or part-time status (include hours worked per week)
- Salary
2. CMS Required Documents (e.g., SF-50, DD-214, SF-15, etc.). Supporting documents may be necessary to be considered for this vacancy announcement. Click here for a detailed description of the required supporting documents. Failure to provide the appropriate documentation WILL result in an ineligible rating OR non-consideration.
3. All College Transcripts. Since this position requires specific education, you must submit a transcript attesting to your possession of the required education. You must submit an unofficial transcript at time of application. If you have preceding education, ensure that you submit all transcripts to potentially receive credit. An official transcript is required if you are selected for the position. If selected, you must provide an original document before the final job offer may be extended.
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.
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 must be submitted by 11:59 PM (ET) on 12/03/2024 of the announcement 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)
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 alexis.coby@cms.hhs.gov. The decision to grant reasonable accommodation will be made on a case-by-case basis.
Commissioned Corps Officers (including Commissioned Corps professionally boarded applicants) who are interested in applying for this position must send their cover letter and professional resume (not PHS Curriculum Vitae) to CMSCorpsJobs@cms.hhs.gov in lieu of applying through this announcement. The resume should specifically explain how you are qualified for this position and draw specific attention to your skills and experiences 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 include only the Job Announcement Number. In the body of your e-mail 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 any interested selecting official(s) at HHS. Clearance of CTAP/ICTAP will be applied for similar positions across HHS.
Pathways Recent Graduates Program
7500 Security Blvd
Woodlawn, MD 21244
US
Next steps
Once your online application is submitted, you will receive a confirmation notification by email. Your application will be evaluated to determine your eligibility and qualifications for the position. After the evaluation is complete, you will receive another email notification regarding the status of your application.
Within 30 business days of the closing date, , 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.
Fair and transparent
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
