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Health Insurance Specialist

Department of Health and Human Services
Centers for Medicare & Medicaid Services

Summary

We are looking to fill Health Insurance Specialist, GS-0107-9, positions in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS). Click on "Learn more about this agency" for more details!

What is a Health Insurance Specialist (HIS)? At CMS, an HIS can wear many hats. This series typically works with health insurance policy development, research, analysis, and program development.

Overview

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Accepting applications
Open & closing dates
03/02/2026 to 03/06/2026
Salary
$51,283 to - $100,315 per year

Please see "Additional Information" for locality pay rates.

Pay scale & grade
GS 9
Locations
Many vacancies in the following locations:
San Francisco, CA
Denver, CO
Washington, DC
Atlanta, GA
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
Recent graduates
Work schedule
Full-time
Service
Excepted
Promotion potential
11 - Please see note in the "Additional Information" section.
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
HHS-CMS-RG-26-12897796
Control number
859028200

This job is open to

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Clarification from the agency

This announcement is open to recent graduates and candidates who will receive their degree by June 30, 2026.

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Duties

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  • Resolve health insurance program issues by conducting research on the problem area, analyzing the results, and making recommendations to management to resolve any problem areas.
  • Engage with senior analysts and management in reviewing, analyzing, and developing program documents.
  • Review, evaluate, and analyze health insurance programs for efficiency and effectiveness.
  • Review draft regulations and responses to CMS' proposed regulations.
  • Assist with the administration of health insurance program audits.

Requirements

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Conditions of employment

  • You must be a U.S. Citizen or National to apply for this position.
  • You must possess a cumulative GPA of 3.0 or higher on a 4.0 scale.
  • You must meet all program, qualification and education requirements.
  • You will be subject to a background and suitability investigation.
  • You must sign a Pathways Participant Agreement before starting employment.

Qualifications

PROGRAM REQUIREMENTS: You must be ELIGIBLE and QUALIFIED in order to be referred to Hiring Managers.

ELIGIBILITY REQUIREMENTS: Am I considered a Recent Graduate?


GPA Requirement: You must possess a cumulative GPA of 3.0 on the unweighted 4.0 scale upon completion of your academic degree or certificate program. (GPA 2.95 is rounded to 3.0 and 2.94 is rounded to 2.9.)

To be eligible as a Recent Graduate:

  • Individuals who, within the previous 2 years, completed a qualifying associate's, bachelor's, master's, professional, doctorate, vocational, or technical degree or certificate from a qualifying educational institution. Therefore, you must have completed your educational program no earlier than March 6, 2024. Veterans who were precluded from applying due to their military service obligation begin their 2-year eligibility period upon release or discharge from active duty. Eligibility for veterans cannot exceed 6 years from the date on which they completed their degrees (or certification). Therefore, veterans must have completed their educational program no earlier than March 6, 2020.
  • To verify your eligibility as a Recent Graduate, you must submit the following at the time of application: A copy of your unofficial transcripts from the educational institution you attended attesting to your possession of the required education. Your unofficial transcripts must reflect: (1) your name; (2) overall grade point average (GPA); and (3) Degree Type (e.g., Bachelor's, Master's, etc.) and Degree Major; AND (4) the date your Degree was conferred. Failure to submit proof of degree/certificate completion at time of application will result in the withdrawal of your application from consideration for this position.
To be eligible as a Degree Candidate for Spring 2026:
  • Individuals who are degree candidates for this current semester/term, i.e., Spring 2026, scheduled to complete a qualifying Associate's, Bachelor's, Master's, Doctorate, professional, vocational, or technical degree or certificate program, AND the degree/certificate has not been conferred at the time of application.
  • To verify your eligibility as a Degree Candidate for Spring 2026, you must submit the following at the time of application: A copy of your unofficial transcripts from the educational institution you attended attesting to your education completed to date. Your unofficial transcripts must reflect: (1) your name; (2) overall grade point average (GPA); (3) current enrollment; AND (4) Degree Type (e.g., Bachelor's, Master's, etc.) and Degree Major. If referred and selected, you must submit an additional unofficial transcript that confirms the date your degree was conferred before an Official Offer can be made. Degree must be conferred by June 30, 2026. Failure to submit proof of degree/certificate completion will result in the withdrawal of your application from consideration for this position.
Note: For those applying as Degree Candidates for Spring 2026, you will be required to submit an additional transcript that confirms the above major or course requirements and the date your degree was conferred. Degree requirements must be completed during the Spring 2026 semester, and the degree must be conferred by June 30, 2026. Failure to submit proof of degree/certificate completion will result in the withdrawal of your application from consideration for this position.

QUALIFICATION REQUIREMENTS: Do I qualify at the GS-09 Grade Level?

In order to qualify for the GS-09, you must meet one of the following:
  • Specialized Experience: 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) performing routine analytical studies related to healthcare programs or policies; and 2) assisting with developing health insurance operational guidance policies, reports, or procedures.
    - OR -
  • Substitution of Education for Experience: You may substitute education for specialized experience at the GS-09 grade level by possessing a Master's Degree or equivalent graduate degree or at least 2 full years of progressively higher level graduate education leading to such a degree or LL.B. or J.D. - 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 GS-09 grade level. Therefore, only education in excess of one full year of graduate-level education may be used to combine education and experience.
ALL TRANSCRIPTS are required at the time of application 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 on what documentation is required.

NOTE: If you are using specialized experience to qualify for this position, 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.

NOTE: A certificate program is defined as post-secondary education, in a qualifying educational institution, equivalent to at least one academic year of full-time study (30 undergrad credits/18 grad school credits) that is part of an accredited college-level, technical, trade, vocational, or business school curriculum.

Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/12897796

Additional information

Bargaining Unit Position: Yes-American Federation of Government Employees, Local 1923
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.

Salary Range by Grade:
Atlanta, GA:

GS-07: $53,361- $69,371
GS-09: $65,271 - $84,857
Bethesda, MD, Woodlawn, MD, and Washington, DC:
GS-07: $57,736 - $75,059
GS-09: $70,623- $91,815
Boston, MA:
GS-07: $57,150 - $74,297
GS-09: $69,905 - $90,882
Chicago, IL:
GS-07: $56,409 - $73,333
GS-09: $68,999 - $89,703
Dallas, TX:
GS-07: $54,857 - $71,315
GS-09: $67,100 - $87,235
Denver, CO:
GS-07: $56,262 - $73,142
GS-09: $68,819 - $89,470
Kansas City, MO:
GS-07: $51,283 - $66,670
GS-09: $62,729 - $81,553
New York, NY:
GS-07: $59,465 - $77,306
GS-09: $72,737 - $94,563
Philadelphia, PA:
GS-07: $55,602 - $72,285
GS-09: $68,013 - $88,421
San Francisco, CA:
GS-07: $63,081 - $82,007
GS-09: $77,161 - $100,315
Seattle, WA:
GS-07: $56,715 - $73,731
GS-09: $69,373 - $90,190

For more information about pay based on locality, please visit the Office of Personnel Management (OPM) Salaries & Wages Page.

Conversion Eligibility: Recent Graduates may be eligible for non-competitive conversion to a career, career-conditional, or term appointment after successful completion of the Pathways Recent Graduate program. The position to which converted may have a full-performance level up to a GS-12.

NOTE - Full Performance Level (FPL): Employees selected for this position may be eligible for promotion up to the GS-11 level while in the Pathways Program and up to the GS-12 level after successful completion of the Program. There is no obligation to provide future promotions if you are selected.

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

Recent Graduate candidates will meet the qualification requirement consistent with the OPM qualification standards applicable to the position being filled. Recent Graduate candidates who meet all requirements will be placed in one of the following categories based on category rating and selection procedures:
  • 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.

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). Veterans' preference applies to selections made under the Pathways authority in accordance with Part 302 of 5 Code of Federal Regulations (CFR).

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