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Health Insurance Specialist

Department of Health and Human Services
Centers for Medicare & Medicaid Services
CMCS- Center for Medicaid and CHIP Services

Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS)/ The Center for Medicaid and CHIP Services, Office of Rural Health Transformation.

As a Health Insurance Specialist, GS-0107-12, you will perform program policy work related to national health insurance programs, such as Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and Marketplace Exchange/private health insurance.

Overview

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Accepting applications
Open & closing dates
02/02/2026 to 02/06/2026
Salary
$102,415 to - $133,142 per year
Pay scale & grade
GS 12
Location
1 vacancy in the following location:
Washington, DC
Remote job
No
Telework eligible
Yes—as determined by the agency policy.
Travel Required
Occasional travel - 10% or less- You may be expected to travel for this position.
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-CMCS-26-12872330-IT
Control number
855610000

This job is open to

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Clarification from the agency

Career Transition Assistance Plan Eligible; 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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  • Interpret statute and develop Federal regulations, policy statements, and other program guidance.
  • Develop, evaluate, refine and review regulations, rulings, manuals, program guidelines, program memoranda, policy letters, and/or instructions to effectively communicate and disseminate program policies related to CMS’ lines of business.
  • Work with States, other key stakeholders, and CMS staff to identify and address evolving program issues or to provide guidance on programmatic matters.
  • Respond to inquiries regarding program policies to a variety of internal and external stakeholders (e.g., beneficiaries, providers, and representatives of public and private organizations, congressional staff, and other government organizations).
  • Attend meetings and conferences with CMS staff and serve as a source of background data on the basis of research performed in preparation for the meetings and conferences.

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-12 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-11 grade level in the Federal government, obtained in either the private or public sector, to include:

  1. Analyzing national health insurance program policies (i.e. Medicare, Medicaid, Marketplace) issues to provide technical support or to make policy recommendations; AND
  2. Refining regulations, manuals, program guidelines, program memoranda, policy letters, and/or instructions to communicate health insurance program policies; AND
  3. Presenting findings or recommendations based on analysis of health insurance programs.

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/12872330

Education

This job does not have an education qualification requirement.

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.

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. 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
  • Integrity/Honesty
  • Interpersonal Skills
  • Reading Comprehension
  • 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.

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