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Division Director, Policy and Evidence Review

Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Clinical Standards and Quality (CCSQ)

Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Clinical Standards and Quality (CCSQ), Coverage & Analysis Group (CAG), Division of Policy & Evidence Review (DPER).

As a Supervisory Physician, referred to as Division Director, Policy and Evidence Review, GP-0602-15, you will lead a staff in preparing clinical and procedural materials to recommend action regarding Medicare coverage and services.

Overview

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Accepting applications
Open & closing dates
12/03/2025 to 12/16/2025
Salary
$125,133 to - $162,672 per year

You may be authorized for special market pay, in addition to the BASE pay listed, dependent on individual experience and credentials.

Pay scale & grade
GP 15
Locations
1 vacancy in the following locations:
Atlanta, GA
Woodlawn, MD
New York, NY
Remote job
No
Telework eligible
Yes—as determined by the agency policy.
Travel Required
Occasional travel - You may be expected to travel up to 5% for this position.
Relocation expenses reimbursed
No
Appointment type
Permanent
Work schedule
Full-time
Service
Competitive
Promotion potential
15
Job family (Series)
Supervisory status
Yes
Security clearance
Not Required
Drug test
No
Position sensitivity and risk
Moderate Risk (MR)
Trust determination process
Financial disclosure
No
Bargaining unit status
No
Announcement number
CMS-CCSQ-26-12835847-PPP
Control number
851334100

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 a multi-disciplinary team of clinical and policy professionals to prepare clinical, and procedural materials in support of the decisions made using the statutory Medicare coverage process
  • Serve as a national medical expert and resource to HHS and CMS leadership, as well as other internal and external stakeholders, on the national coverage determinations and related coverage policies (e.g., regulations).
  • Act as a confidential Medical Advisor to the Center Director, CMS Chief and Deputy Chief Medical Officers and higher levels of Agency and Departmental leadership on critical decisions associated with legislative to improve coverage methodologies.
  • Oversee medical consultation of outside experts in the national coverage process through the Medicare Evidence Development and Coverage Advisory Committee (MEDCAC).
  • Direct projects teams to ensure project management, quality management, performance, risk/issue management are integrated within the program and closely followed.

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.
  • The incumbent must possess a Doctor of Medicine (M.D.) or Doctor of Osteopathy (D.O.).
  • The incumbent must hold a current license to practice medicine in a State or territory of the United States or in the District of Columbia. Medical license must be maintained throughout duration of the appointment.
  • The incumbent must possess an Active Board Certification in a recognized medical specialty, which must be maintained throughout duration of appointment.

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-15, you must meet the following: You must demonstrate in your resume 5 years of graduate training in the specialty of the position to be filled or equivalent experience and training.

  1. Interviews: Applicants may be interviewed to assure that they possess the degree of skill in interpersonal relationships required for satisfactory performance of the duties of the position to be filled.
  2. Substitution of Experience for Residency Training: Experience may not be substituted for residency training that is essential for the performance of specialized duties. For example, specialists such as psychiatrists and surgeons must complete the number of years of accredited residency training required in their respective specialties. An exception may be made when a peer panel of physicians (subject-matter experts) determines and documents that the knowledge, skills, and abilities acquired in professional medical practice are equivalent to those acquired during the same period of time in a graduate training program.
  3. Teaching Experience: Graduate teaching experience as a member of the faculty in a school of medicine or school or public health may be credited for training positions or as appropriate for specialist positions. (Teaching undertaken as a part of a residency or fellowship training does not satisfy this requirement).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.

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

Education Requirement: In addition to meeting the qualification requirements, all candidates must have the following educational requirements:

Degree: Doctor of Medicine, Doctor of Osteopathic Medicine or equivalent from a school in the United States or Canada. This degree must have been accredited by the Council on Medical Education of the American Medical Association (external link); Association of American Medical Colleges (external link); Liaison Committee on Medical Education (external link); Commission on Osteopathic College Accreditation of the American Osteopathic Association (external link), or an accrediting body recognized by the U.S. Department of Education (external link) at the time the degree was obtained. (TRANSCRIPTS REQUIRED AT TIME OF APPLICATION)

Degree from Foreign Medical School: A Doctor of Medicine or equivalent degree from a foreign medical school must provide education and medical knowledge equivalent to accredited schools in the United States. Evidence of equivalency to accredited schools in the United States is demonstrated by permanent certification by the Educational Commission for Foreign Medical Graduates (external link), a fifth pathway certificate for Americans who completed premedical education in the United States and graduate education in a foreign country, or successful completion of the U.S. Medical Licensing Examination. Graduate Training: Subsequent to obtaining a Doctor of Medicine or Doctor of Osteopathic Medicine degree, a candidate must have had at least 1 year of supervised experience providing direct service in a clinical setting, i.e., a 1-year internship or the first year of a residency program in a hospital or an institution accredited for such training. For purposes of this standard, graduate training programs include only those internship, residency, and fellowship programs that are approved by accrediting bodies recognized within the United States or Canada. (TRANSCRIPTS REQUIRED AT TIME OF APPLICATION)

You are strongly encouraged to submit a copy of your transcripts at the time of application. Unofficial transcripts will be accepted at the time of application. Official transcripts will be required from all selectees prior to receiving an official offer.

Board Certification: You must possess an active Board Certification in a recognized medical specialty, which must be maintained throughout the duration of the appointment. (PROOF OF BOARD CERTIFICATION REQUIRED AT TIME OF APPLICATION).

License/Registration Requirement: In addition to meeting the qualification requirements, applicants must possess a current, active, full, and unrestricted license or registration as a Physician from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States. Proof of License/Registration is required at the time of application to verify possession of the license/registration listed above.

Failure to submit proof of license/registration at the time of application WILL result in an ineligible rating. Please see the "Required Documents" section below for more information.

Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/12835847

Additional information

Bargaining Unit Position: No.
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. CMS offers flexible working arrangements and allows employees the opportunity to participate in alternative work schedules at the manager's discretion.

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.

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.

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 assessements required for this position. A Subject Matter Expert may assist in the resume review process to help determine whether you meet the minimum job qualifications. Please follw all instructions carefully. Errors or omissions may affect your rating.

A Crediting Plan will be used to determine insofar as to how you meet the following Factors/Competencies:

  • Medical Officer
  • Leading People
  • Building Coalitions/Communications
  • Managing Change
  • Results Driven
  • Business Acumen
If you are found to be among the top qualified candidates, you will be referred to the selecting official for employment consideration.

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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