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Health Insurance Specialist (Medicare Administrative Contractor COR III)

Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Medicare (CM), Medicare Contractor Management Group (MCMG)

Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare (CM), Medicare Contractor Management Group (MCMG), Western MAC Program Management Division (WMPMD).

As a Health Insurance Specialist (Medicare Administrative Contractor COR III), GS-0107-14, you will serve as a Contracting Officer's Representative (COR) for the needs and requirements for one or more assigned Medicare Administrative Contractors (MACs).

Overview

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Accepting applications
Open & closing dates
02/12/2026 to 02/22/2026
Salary
$136,736 to - $187,093 per year

Locality pay rate will be contingent on the duty station selected. Please see "Additional Information" for locality pay rates.

Pay scale & grade
GS 14
Locations
1 vacancy in the following locations:
Denver, CO
Boston, MA
Woodlawn, MD
Dallas, TX
Remote job
No
Telework eligible
Yes—as determined by the agency policy.
Travel Required
25% or less - You may be expected to travel up to 20% for this position.
Relocation expenses reimbursed
No
Appointment type
Permanent
Work schedule
Full-time
Service
Competitive
Promotion potential
14
Supervisory status
No
Security clearance
Not Required
Drug test
No
Position sensitivity and risk
Moderate Risk (MR)
Trust determination process
Financial disclosure
Yes
Bargaining unit status
Yes
Announcement number
CMS-CM-26-12879356-ST
Control number
857369300

This job is open to

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Clarification from the agency

Career Transition Assistance Plan Eligibles; OR Current Permanent Career and Career-Conditional Employees in the Department of Health and Human Services (HHS)

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Duties

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  • Accountable for the successful performance of all functions detailed in the Statements of Work (SOW) for their assigned MACs and the oversight of contractor operations.
  • Conduct periodic analysis of contractor’s performance and cost data to identify any systemic issues, trends, or concerns for discussion.
  • Plan and develop the detailed specifications for the MACs, including the direction, operation, and implementation requirements.
  • Perform analyses of operational policy and program operations to evaluate the appropriateness, cost effectiveness, or other impact resulting from the implementation of law, regulations, policy, or operational procedures and systems.
  • Review deliverables and advises OAGM of the assigned MACs’ performance and advises them regarding contractors' compliance with technical and performance requirements.

Requirements

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Conditions of employment

  • Certifications Required: Must be able to obtain and maintain a COR III Certification at a minimum.
  • You must be a U.S. Citizen or National to apply for this position.
  • 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-14
, 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-13 grade level in the Federal government, obtained in either the private or public sector, to include: 1) Administering health-related or insurance-related contracts; AND 2) Developing or evaluating Medicare policies or contracts; AND 3) Leading projects or teams related to contract administration.

You Must be able to obtain and maintain a COR III Certification. (Note: Documentation demonstrating that you possess your COR III Professional must be uploaded at time of application)

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/12879356

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: OGE-450 Required
GS-14 Salary Ranges:
Boston, MA: $142,452 -$185,193/year
Dallas, TX: $136.736 -$177,762/year
Denver, CO: $140,239 - $182,316/year
Woodlawn, MD: $143,913 - $187,093/year

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 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):

  • 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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