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Health Insurance Specialist

Department of Health and Human Services
Centers for Medicare & Medicaid Services
This job announcement has closed

Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Medicare Drug Benefit and C&D Data Group, Division of Part D Policy.

As a Health Insurance Specialist, GS-0107-14, you will develop, evaluate, and implement Medicare prescription drug benefit policies.

Overview

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Reviewing applications
Posted this month
Location
Work site options
Telework eligible
Yes—as determined by the agency policy.
Remote job
No
Relocation expenses reimbursed
No
Salary
$143,913 - $187,093 per year
Pay scale & grade
GS 14
Pay scale and grade determines the salary of the job.
Work schedule
Full-time
Travel Required
Occasional travel - You may be expected to travel for this position.
Appointment type
Permanent
Occupations and job series
Supervisory status
No
Federal service type
This job is in the Competitive Service
Represented by a union
Yes
Drug test
No
Security clearance
Not Required
Position sensitivity and risk
Moderate Risk (MR)
Jobs require a background check and some require a security clearance. The type depends on the job.
Background check type
Financial disclosure required
Yes
Some jobs require financial disclosure to identify conflicts of interests.
Announcement number
CMS-CM-26-12956624-DE
Control number
868542400

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Duties

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  • Performing analytical studies and evaluate prescription drug benefits in policy areas related to access to Title XVIII, Part D plans, Part D benefit design.
  • Serving as lead for coordination of benefits between other payors and Part D organizations, as well as the low-income subsidy program under Part D.
  • Serving as the agency’s primary liaison for external stakeholders on pharmacy transaction standards.
  • Influencing major Federal program decisions and legislative proposals through policy analysis and recommendations.
  • Building and maintaining collaborative relationships with Centers and Groups within CMS and HHS to advance electronic pharmacy standards and coordination of benefits operations and policy.

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. Providing technical expertise for electronic pharmacy transaction standards and coordination of benefit (COB) initiatives and activities related to legislation, regulation and program policy; AND
2. Identifying potential improvements or changes for the Medicare Part D program and making recommendations to implement such solutions; AND
3. Communicating technical and detailed information in a variety of formats such as regulations, briefing papers, and presentations.

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/12956624

Education

This job does not have an education qualification requirement.

Additional information

Bargaining Unit Position: Yes
Tour of Duty: Flexible
Recruitment Incentive: Not Authorized
Relocation Incentive: Not Authorized
Financial Disclosure: Required: OGE-450

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 will 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, Influencing/Negotiating, Integrity/Honesty, Interpersonal Skills, Learning, 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.

The assessment includes a cut score based on the minimum level of required proficiency in these critical general competencies. You must meet or exceed the cut score to be considered. You will not be considered for the position if you score below the cut score or fail to complete the assessment.

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.

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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