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Health Insurance Specialist, One Big Beautiful Bill Provisions

Department of Health and Human Services
Centers for Medicare & Medicaid Services
Office of Strategic Operations & Regulatory Affairs (OSORA)

Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Office of Strategic Operations and Regulatory Affairs,(OSORA) .

As a Health Insurance Specialist, referred to here as a Health Insurance Specialist, One Big Beautiful Bill Provisions, GS-0107-9/11/12,you will support leadership in policy development and program implementation by overseeing the internal clearance and coordination of executive decision-making processes.

Overview

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Accepting applications
Open & closing dates
12/02/2025 to 12/12/2025
Salary
$69,923 to - $131,826 per year

Please see the "Additional Information" section below for additional salary information.

Pay scale & grade
GS 9 - 12
Location
2 vacancies in the following location:
Washington, DC
Remote job
No
Telework eligible
Yes—as determined by the agency policy.
Travel Required
Not required
Relocation expenses reimbursed
No
Appointment type
Permanent
Work schedule
Full-time
Service
Competitive
Promotion potential
12
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-OSORA-26-12840195-PPP
Control number
851247900

This job is open to

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Clarification from the agency

Career transition (CTAP, ICTAP, RPL) within the local commuting area from where you were separated.

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Duties

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  • Oversee the administrative functions of the agency’s clearance and decision-making processes, and associated clearance processing systems.
  • Develop standards, processes, and procedures to ensure consistency across the continuum.
  • Track the development and progression of CMS priorities. Negotiate timelines and priorities with internal and external stakeholders.
  • Maintain broad awareness of current and emerging issues impacting CMS’ programs and policies. Synthesizes internal and external sources of information to improve the coordination of executive-level clearances.
  • Produce high-quality, error-free documents for the Administrator’s review, approval, signature, and public release.

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-09, 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-07 grade level in the Federal government, obtained in either the private or public sector, to include: 1) Assisting in cultivating partnerships with internal and external stakeholders to manage competing priorities, establish timelines, achieve consensus, and drive effective conflict resolution; 2) Supporting operational processes that ensure procedural consistency, workflow efficiencies, and statutory compliance; AND 3) Assisting in monitoring national health insurance programs (such as Medicare, Medicaid, or private marketplaces) to support executive decision-making.
- OR -
Substitution of Education for Experience: You may substitute education for specialized experience at the GS-09 level by possessing a Master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree or LL.B. or J.D., if related to the position being filled.
- 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 grade GS-09. Therefore, only education in excess of 1 full year of graduate level education may be used to combine education and experience.

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.

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: 1) Cultivating partnerships with internal and external stakeholders to manage competing priorities, establish timelines, achieve consensus and effective conflict resolution; 2) Assisting in managing operational processes that ensure procedural consistency, workflow efficiencies, and statutory compliance; AND 3) monitoring and analyzing national health insurance programs (such as Medicare, Medicaid, or private marketplaces) to support executive decision-making.
- OR -
Substitution of Education for Experience: You may substitute education for specialized experience at the GS-11 level by possessing a Ph.D. or equivalent doctoral degree or 3 full years of progressively higher level graduate education leading to such a degree or equivalent doctoral degree or LL.M., if related to the position being filled.
- OR -
Combination of Experience and Education: Only graduate education in excess of the amount required for the GS-09 grade level may be used to qualify applicants for positions at the grade GS-11. Therefore, only education in excess of a master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree, may be used to combine education and experience.

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.

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: 1) Cultivating partnerships with internal and external stakeholders to manage competing priorities, establish timelines, achieve consensus and effective conflict resolution; 2) Managing operational processes that ensure procedural consistency, workflow efficiencies, and statutory compliance; AND 3) Monitoring and analyzing national health insurance programs (such as Medicare, Medicaid, or private marketplaces) to inform executive decision-making and support implementation.

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.

Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/12840195

Additional information

Bargaining Unit Position: Yes-American Federation of Government Employees, Local 1923
Tour of Duty: Flexible
Recruitment Incentive: Not Authorized
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. CMS offers flexible working arrangements and allows employees the opportunity to participate in alternative work schedules at the manager's discretion.

Additional Salary Information:
GS-9: $69,923 - $90,898
GS-11: $84,601 - $109,975
GS-12: $101,401 - $131,826

Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.

How you will be evaluated

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

You will be evaluated based on how well you meet the qualifications listed in this vacancy announcement. Your qualifications will be evaluated based on your application materials (e.g., resume, supporting documents), the responses you provide on the application questionnaire, and the result of the online assessments required for this position. Please follow all instructions carefully. Errors or omissions may affect your rating.

You will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics):

  • Attention to Detail
  • Customer Service
  • Decision Making
  • Flexibility
  • Influencing/Negotiating
  • Integrity/Honesty
  • Interpersonal Skills
  • Learning
  • Reasoning
  • Self-Management
  • Stress Tolerance
  • Teamwork
In order to be considered for this position, you must complete all required steps in the process. In addition to the application and application questionnaire, this position requires an online assessment. The online assessment measures critical general competencies required to perform the job.

Overstating your qualifications and/or experience in your application materials or application questionnaire may result in your removal from consideration. Cheating on the online assessment may also result in your removal from consideration.

You will be placed in one of the following categories based on category rating and selection procedures if you meet all of the requirements outlined in this job opportunity announcement:
  • 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

If you are found to be among the top qualified candidates, you will be referred to the selecting official for employment consideration.

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.

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).

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