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Nurse (Payment Policies and Programs)

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), Hospital & Ambulatory Policy Group (HAPG), Division of Outpatient Care (DOC).

As a Nurse (Payment Policies and Programs), GS-0610-13, you will provide clinical practice advice, formulate policies, and assess the integrity and quality of clinical aspects that influence CMS-administered healthcare financing programs.

Overview

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Accepting applications
Open & closing dates
04/10/2026 to 04/23/2026
Salary
$121,785 - $158,322 per year
Pay scale & grade
GS 13
Location
1 vacancy 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
13
Job family (Series)
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-CM-26-12911112-DH
Control number
864487100

This job is open to

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Clarification from the agency

This announcement is advertised under Direct Hire Authority and is open to all United States Citizens or Nationals.

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Duties

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  • Develop, evaluate, and interpret national health care payment policies related to Medicare, providing clinically informed recommendations regarding payment systems or nursing practice implications.
  • Conduct complex policy analyses and program evaluations, such as analysis of Medicare Prospective Payment Systems (PPS).
  • Provide expert clinical consultation and technical guidance to CMS leadership, contractors, and external stakeholders on clinical policy issues, healthcare delivery trends, and regulatory implementation.
  • Prepare high-level policy documents and communications, including regulatory text, briefing materials, manuals, and operational guidance related to CMS programs.
  • Plan and conduct meetings with other CMS components and external partners and organizations and contribute to discussions and planning sessions on program policy developments.

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.
  • Must have passed the National Council Licensure Examination (NCLEX).
  • Must possess a current, active, full, and unrestricted license or registration as a professional nurse (i.e., RN) from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

Qualifications

ALL QUALIFICATION REQUIREMENTS MUST BE MET BY 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-13 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-12 grade level in the Federal government, obtained in either the private or public sector, to include:
1) Providing clinically informed input into policy recommendations related to Medicare payment; AND
2) Analyzing data from healthcare payment systems, for example, Prospective Payment Systems (PPS), related to provider billing and operations; AND
3) Providing clinical nursing or program guidance on the application of payment provisions.

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:-Possess a graduate or higher-level degree, bachelor's degree, associate degree, or diploma from an accredited professional nursing educational program is required. This education must have been accredited by the Commission on Collegiate Nursing Education, Council on Accreditation of Nurse Anesthesia Educational Programs, Accreditation Commission for Midwifery Education, or an accrediting body recognized by the U.S. Department of Education at the time the degree was obtained. Official certification from the Commission on Graduates of Foreign Nursing Schools is required for individuals who graduated from foreign nursing schools. (TRANSCRIPTS REQUIRED AT 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.

License/Registration Requirement: In addition to meeting the qualification requirements, all candidates must possess the license/registration listed below. Proof of license/registration MUST be submitted at time of application. Failure to submit proof of license/registration at the time of application WILL result in an ineligible rating.
-A current, active, full, and unrestricted license or registration as a professional Nurse (i.e., RN) 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/12911112

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 in the application questionnaire, and the results of the online assessment(s) 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 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
  • Customer Service
  • Decision Making
  • Flexibility
  • Integrity/Honesty
  • Interpersonal Skills
  • Learning
  • Reasoning
  • Self-Management
  • 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.

RPL Applicants
RPL applicants who are verified as registered for the same series, grade, and location as this vacancy announcement will be placed in one of the following categories based on category rating procedures:
  • Best Qualified - significantly exceeds the evaluation criteria
  • Well Qualified - excelsin the evaluation criteria
  • Qualified - meets 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 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).

Centers for Medicare & Medicaid Services

The Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS) works in partnership with the entire health care community to improve quality and efficiency in an evolving health care system and provides leadership in the broader health care marketplace.

CMS' effectiveness depends on the capabilities of a dedicated, professional staff that is committed to supporting these objectives. A career with CMS offers the opportunity to get involved in important national health care issues and be part of a dynamic, fast-paced, and highly visible organization. For more information on CMS, please visit: http://www.cms.gov/.

HHS has a critical preparedness and response mission: HHS protects the American people from health threats, researches emerging diseases, and mobilizes public health programs with domestic and international partners. In support of this mission, HHS offers its employees the opportunity to contribute their unique skills through voluntary temporary assignments to humanitarian emergencies or Departmental priorities countering new and emerging health, safety, and security threats.

Agency contact information

CMS HR Inquiries
Email
hrinquiries@cms.hhs.gov
Address
Center for Medicare
7500 Security Blvd
Woodlawn, MD 21244
US

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