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Supervisory Health Insurance Specialist (Division Director)

Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Medicare (CM)

Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare (CM), Division of Institutional Post Acute Care OR Division of Chronic Care Management.

As a Supervisory Health Insurance Specialist, referred to here as a Supervisory Health Insurance Specialist (Division Director), GS-0107-15, you will lead Medicare payment policy development for multiple types of providers and facilities.

Overview

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Accepting applications
Open & closing dates
12/19/2025 to 01/07/2026
Salary
$167,603 to - $195,200 per year
Pay scale & grade
GS 15
Location
2 vacancies in the following location:
Woodlawn, MD
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
Supervisory status
Yes
Security clearance
Not Required
Drug test
No
Position sensitivity and risk
Moderate Risk (MR)
Trust determination process
Financial disclosure
Yes
Bargaining unit status
No
Announcement number
CMS-CM-26-12854348-ST
Control number
852792100

This job is open to

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Clarification from the agency

Career Transition Assistance Plan Eligibles separated from within the local commuting area of Woodlawn, MD; OR Current Permanent Career and Career-Conditional Employees in the Department of Health and Human Services.

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Duties

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  • Plan, assign, evaluate, and coordinate the work of a professional staff; manage performance, resolve grievances, approve training and leave requests, and foster a productive and inclusive workplace.
  • Lead development, analysis, and implementation of Medicare payment policy; interpret regulations; propose modifications to address health care needs and system changes.
  • Develop, evaluate, and oversee regulations, manuals, guidelines, program instructions, and policy communications for payment systems.
  • Advise senior leadership; ensure alignment with CMS/HHS strategy; negotiate schedules, deliverables, and solutions to sensitive issues.
  • Prepare briefings, regulatory language, and talking points; engage with industry associations; provide expert technical assistance.

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 (limited to no more than 2 pages) 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 being considered further.


In order to qualify for the GS-15 grade level, 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-14 grade level in the Federal government, obtained in either the private or public sector, to include:
1) Developing and overseeing Medicare payment policies, regulations, standards, or instructions for programs such as Skilled Nursing Facilities (SNF), End Stage Renal Disease (ESRD), Inpatient Rehabilitation Facilities (IRF), Inpatient Psychiatric Facility (IPF), or other reasonable cost-based payment systems; AND
2) Providing technical guidance related to Medicare payment systems; AND
3) Managing the work of multidisciplinary teams or contractors. For example, setting priorities, coordinating schedules, directing technical and analytical work streams, ensuring timely and high-quality deliverables, and utilizing performance assessments or process improvements to support effective policy development and program operations.

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 or former Federal employees and current or former Federal employees applying under the VEOA eligibility who hold or have held a permanent General Schedule position in the previous year 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/12854348

Education

This job does not have an education qualification requirement.

Additional information

Bargaining Unit Position: No
Tour of Duty: Flexible
Recruitment Incentive: Not Authorized
Relocation Incentive: Not Authorized
Financial Disclosure: 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 Clarification: This posting combines two Division Director vacancies within CM's Chronic Care Policy Group (CCPG); One vacancy for the Division of Institutional Post-acute Care (DIPC), and one vacancy for the Division of Chronic Care Management (DCCM). Candidates may be placed in either of these divisions within the Chronic Care Policy Group (CCPG).

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.

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 results of the online assessments required for this position. A Subject Matter Expert will assist in the resume review process to help determine whether you meet the minimum job qualifications. 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):

Accountability
Customer Service
Decisiveness
Flexibility
Interpersonal Skills
Problem Solving
Resilience


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.

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