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Health Insurance Specialist

Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Consumer Information and Insurance Oversight (CCIIO)

Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Consumer Information and Insurance Oversight (CCIIO).

As a Health Insurance Specialist, GS-0107-9/11/12, you will perform program policy work related to national health insurance programs, such as Medicare, Medicaid, the Children's Health Insurance Program (CHIP), Marketplace Exchange/private health insurance.

Overview

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Accepting applications
Open & closing dates
05/14/2026 to 05/20/2026
Salary
$65,271 - $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
8 vacancies in the following locations:
Atlanta, GA
Woodlawn, MD
Philadelphia, PA
Dallas, TX
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
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-CCIIO-26-12958067-DE
Control number
869212200

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Duties

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  • Interpret statute and develop Federal regulations, policy statements, and other program guidance.
  • Propose modifications to policies to reflect changes or trends in the health care industry, program objectives and the needs of beneficiaries.
  • Review and evaluate proposed, modified, or new legislation and regulations to assess the impact on CMS programs.
  • Provide technical assistance to stakeholders (e.g., Medicare, Medicaid, and/or private insurance that provide health care and drug services, and Providers), on CMS requirements.

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 Selection 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-09, 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-07 grade level in the Federal government, obtained in either the private or public sector, to include:
1) Assisting with the review of proposed, modified, or new legislation to assess the impact on national health insurance programs; AND

(2) Preparing position papers or briefing materials used by others on national health insurance program policy related activities; AND

(3) Working with stakeholders on national health insurance program issues of a routine or procedural nature.

- 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 one 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 substitution of education for experience and combination of experience and education. Please see "Required Documents" section below for what documentation is required at the time of application.

In order to qualify for the GS-11, 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-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 program policy in order to make recommendations; AND

2) Reviewing regulations, manuals, program guidelines, program memoranda, policy letters, or instructions to communicate health insurance program policies; AND

(3) Working with stakeholders to resolve problems pertaining to 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 or equivalent graduate degree, 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 substitution of education for experience and combination of experience and education. Please see "Required Documents" section below for what documentation is required at the time of application.

In order to qualify for the GS-12, 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-11 grade level in the Federal government, obtained in either the private or public sector, to include:

(1) Researching national health insurance program policy issues in order to propose policy modifications; AND

2) Developing regulations, manuals, program guidelines, program memoranda, policy letters, or instructions to communicate health insurance program policies; AND

(3) Presenting recommendations to stakeholders based on analysis of health insurance programs.

Substitution of Education for Experience: There is no substitution of education to meet the specialized experience requirement at the GS-12 grade level.

Combination of Experience and Education: There is no combination of experience and education to meet the specialized experience requirement at the GS-12 grade level.

Experience refers to both 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/12958067

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

Dallas, TX:
GS-09: $67,100 to $87,235
GS-11: $81,186 to $105,547
GS-12: $97,307 to 126,502

Philadelphia, PA:
GS-09: $68,013 to $88,421
GS-11: $82,289 to $106,982
GS-12: $98,630 to $128,221

Seattle, WA:
GS-09: $69,373 to $90,190
GS-11: $83,935 to $109,122
GS-12: $100,602 to $130,786

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 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
  • Integrity/Honesty
  • Interpersonal Skills
  • 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
Center for Consumer Information and Insurance Oversight
7500 Security Blvd
Woodlawn, MD 21244
US

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