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Health Insurance Specialist

Department of Health and Human Services
Centers for Medicare & Medicaid Services
Federal Coordinated Health Care Office (FCHCO)

Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Federal Coordinated Health Care Office (FCHCO), Program Alignment Group (PAG).

As a Health Insurance Specialist, GS-0107-14, you will serve as a technical authority and expert in the development, evaluation, and implementation of policies related to dual eligible individuals, CMS programs serving dual eligible individuals, and/or other policy areas of responsibility.

Overview

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Accepting applications
Open & closing dates
05/01/2026 to 05/08/2026
Salary
$127,829 - $187,093 per year
Pay scale & grade
GS 14
Locations
2 vacancies in the following locations:
Woodlawn, MD
Kansas City, MO
Philadelphia, PA
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
14 - The full performance level of this position is GS-14
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 - American Federation of Government Employees, Local 2268
Announcement number
CMS-FCHCO-26-12949908-DE
Control number
867429500

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Duties

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  • Serve as a Technical Authority on dual-eligible policy: lead analyses of Medicare-Medicaid populations, research legislative intent, and develop evidence-based recommendations while assessing economic, technical, and political impacts.
  • Evaluate and develop legislative and regulatory policy: provide expert guidance on proposed or revised laws and regulations, assessing impacts on integrated care models, delivery systems, and financing for dual-eligible populations.
  • Lead policy development to improve program alignment: advance objectives to streamline integrated care, reduce Medicare-Medicaid barriers, and enhance enrollment, marketing, financing, benefits, quality, and program effectiveness nationwide.
  • Provide strategic leadership and engagement: lead cross-agency initiatives and contractor coordination; develop tools and resources; prepare briefings; and represent the agency to advance Medicare-Medicaid alignment.

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.
  • Selective Service: Males born after December 31, 1959, must be registered or exempt from Selective Service - http://www.sss.gov.
  • One-year probationary period may be required.
  • If you are selected for this position, the documentation that you present for purposes of completing the Department of Homeland Security (DHS) form I-9 will be verified through the DHS "E-Verify" System.
  • All Federal employees are required to have Federal salary payments made by direct deposit to a financial institution of their choice.

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-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) Developing written products or briefings such as regulatory text, policy memoranda, training materials, or Congressional correspondence; AND
2) Coordinating workgroups to evaluate Medicare-Medicaid integrated programs; AND
3) Conducting analyses of legislative proposals, regulatory changes, or operational policies to assess programmatic impact; AND
4) Recommending corrective actions to ensure compliance with statutory and regulatory requirements.

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/12949908

Education

Not Applicable.

Additional information

Bargaining Unit Position: Yes - American Federation of Government Employees, Local 2268
Tour of Duty: Flexible
Recruitment Incentive: Not Authorized
Relocation Incentive: Not Authorized
Financial Disclosure: Not Required

Salary Ranges:
Kansas City, MO - $127,829 - $166,182
Philadelphia, PA - $138,595 - $180,178
Woodlawn, MD - $143,913 - $187,093

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. 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
  • Influencing/Negotiating
  • Integrity/Honesty
  • Interpersonal Skills
  • Learning
  • Reading Comprehension
  • 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.

You will be placed in one of the following categories based on category rating and selection procedures if you meet all of the requirements outlined in this job opportunity announcement:
  • Best Qualified - for those who are superior in the evaluation criteria
  • 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.

This is a competitive vacancy announcement advertised under Delegated Examining Authority. Selections made under this vacancy announcement will be processed as new appointments to the civil service. Current civil service employees would therefore be given new appointments to the civil service; however, benefits, time served, and all other Federal entitlements would remain the same.

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).

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
Federal Coordinated Health Care Office
7500 Security Blvd
Woodlawn, MD 21244
US

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