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Health Insurance Specialist

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

Summary

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

As a Health Insurance Specialist, GS-0107-9/11/12, you will perform program policy work related to Medicaid, Children's Health Insurance Program (CHIP), and Basic Health Program (BHP).

Overview

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Accepting applications
Open & closing dates
04/24/2026 to 05/01/2026
Salary
$62,729 - $133,142 per year

This range includes the lowest/highest of all listed grades/duty locations. Please see "Additional Information" for individual locality pay ranges.

Pay scale & grade
GS 9 - 12
Locations
23 vacancies in the following locations:
Atlanta, GA
Boston, MA
Woodlawn, MD
Kansas City, MO
Remote job
No
Telework eligible
Yes—as determined by the agency policy.
Travel Required
Occasional travel - You may be expected to travel up to 10% 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-26-12932106-DH
Control number
866573700

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. Career Transition Assistance Plan (CTAP), Reemployment Priority List (RPL), and Interagency Career Transition Assistance Plan (ICTAP) eligibles only within the Local Commuting area of Atlanta, GA, Boston, MA, Kansas City, MO, Philadelphia, PA or Woodlawn, MD. CTAP, ICTAP, RPL eligible applicants may only select the local commuting area from which they were separated.

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Duties

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  • Perform program policy work related to national health insurance programs, such as Medicaid, Children's Health Insurance Program (CHIP), and Basic Health Program (BHP).
  • Conduct analysis of policy issues and topics, research background information, the origin of laws, and the intended impact in order to make effective policy recommendations.
  • Conduct analytical studies and evaluate the effectiveness of program initiatives by gathering, organizing, and interpreting data.
  • 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.

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 receiving further consideration.


In order to qualify for the GS-09 level position, you must clearly 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. Reviewing proposed, modified, or new health insurance legislation to assess the impact on national health insurance programs; AND
  2. Gathering and analyzing information pertaining to health insurance program policies or operations to prepare various reports and documents.
- OR -
Substitution of Education for Experience: You may substitute education for specialized experience at the GS-09 level by possessing a Master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree or LL.B. or J.D., if related to the position being filled.
- 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 grade GS-09. Therefore, only education in excess of 1 full year of graduate level education may be used to combine education and experience.

TRANSCRIPTS are required to verify satisfactory completion of the educational requirement related to the substitution of education for experience and the combination of experience and education. Please refer to the "Required Documents" section below for the documentation required at the time of application. If selected, official transcripts will be required.

In order to qualify for the GS-11 level position, you must clearly demonstrate in your resume at least one year (52 weeks) of qualifying specialized experience equivalent to the GS-09 grade level in the Federal government, obtained in either the private or public sector, to include:
  1. Assisting with the analysis of national health insurance programs (e.g., Medicare, Medicaid, Marketplace) to address program issues; AND
  2. Assisting with drafting health insurance program technical documents such as options papers or program guidance to communicate health insurance program policies.
- OR -
Substitution of Education for Experience: You may substitute education for specialized experience at the GS-11 level by possessing a Ph.D. or equivalent doctoral degree or 3 full years of progressively higher level graduate education leading to such a degree or equivalent doctoral degree or LL.M., if related to the position being filled.
- OR -
Combination of Experience and Education: Only graduate education in excess of the amount required for the GS-09 grade level may be used to qualify applicants for positions at the grade GS-11. Therefore, only education in excess of a master's degree or its equivalent, or 2 full years of progressively higher-level graduate education leading to such a degree, may be used to combine education and experience.

TRANSCRIPTS are required to verify satisfactory completion of the educational requirement related to the substitution of education for experience and the combination of experience and education. Please refer to the "Required Documents" section below for the documentation required at the time of application. If selected, official transcripts will be required.

In order to qualify for the GS-12 level position, you must clearly 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 Medicaid guidelines to address program policy issues; AND
  2. Drafting various Medicaid-related technical documents such as options papers or program guidance to communicate health insurance program policies; AND
  3. Advising leadership regarding Medicaid program policy analysis.
Substitution of Education for Experience: There is no substitution of education to meet the specialized experience requirement at the GS-12 grade level.

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.

Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/12932106

Additional information

Locality Pay Ranges:
Atlanta, GA:
GS-09: $65,271 to $84,857
GS-11: $78,972 to $102,669
GS-12: $94,654 to $123,052
Boston, MA:
GS-09: $69,905 to $90,882
GS-11: $84,579 to $109,959
GS-12: $101,375 to $131,790
Kansas City, MO:
GS-09: $62,729 to $81,553
GS-11: $75,897 to $98,671
GS-12: $90,968 to $118,261
Philadelphia, PA:
GS-09: $68,013 to $88,421
GS-11: $82,289 to $106,982
GS-12: $98,630 to $128,221
Woodlawn, MD:
GS-09: $70,623 to $91,815
GS-11: $85,447 to $111,087
GS-12: $102,415 to $133,142

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):

  • Customer Service
  • Decision Making
  • Flexibility
  • Integrity/Honesty
  • Interpersonal Skills
  • Reading
  • 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 Medicaid and CHIP Services
7500 Security Blvd
Woodlawn, MD 21244
US

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