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Social Insurance Specialist (CDI Program Specialist)

Social Security Administration
Chief of Risk & Quality (RQ) / Cooperative Disability Investigation (CDI) Support

Summary

See QUALIFICATIONS for important information about this position.

Serves as a program expert for detection and prevention of fraud and abuse and the development and adjudication of claims filed under programs administered by SSA.

See DUTIES for an additional responsibility of this position.

See 6F0530 at PD Search.

Overview

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Accepting applications
Location
2 vacancies in the following locations:
Work site options
Telework eligible
No
Remote job
No
Relocation expenses reimbursed
No
Salary
$76,463 - $99,404 per year

GS-12 Base Salary Only -- salary will be set in accordance with locality pay provisions

Pay scale & grade
GS 12
Promotion potential
None
Pay scale and grade determines the salary of the job.
Work schedule
Full-time
Travel Required
Not required
Appointment type
Permanent
Occupations and job series
Supervisory status
No
Federal service type
This job is in the Competitive Service
Represented by a union
No
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
No
Some jobs require financial disclosure to identify conflicts of interests.
Announcement number
SSA-13064135-26-RQ-IMP
Control number
886275000

This job is open to

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Clarification from the agency

Current permanent SSA employees nationwide. Your resume must identify your organizational assignment and geographic location.

Duties

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  • Serves as a program expert in the review and development of claims filed under the provisions of Titles II, VIII and XVI of the Social Security Act, as amended.
  • Provides technical advice and guidance to staff members in the areas of claims development, interpretation of policy issues, analysis of specific systems queries, such as the MBR, SSR and CDRMS and web-based programs such as eVIEW and eWork, etc.
  • Assists with and provides necessary training to other staff members on SSA programmatic policies.
  • Serves as the primary liaison between SSA Field Offices (FOs) and the CDI Unit, providing feedback through local FO management to Claims Representatives (CRs) on cases.
  • Develops and maintains liaisons between FOs, Office of the Area Director, Office of Disability Adjudication and Review (ODAR) and the State Disability Determination Services (DDS) to promote appropriate fraud referrals.
  • Independently, or as a member of a team, plans, schedules and conducts investigations of suspected acts of fraud in obtaining disability or other need-based benefits under programs administered by SSA.
  • Obtains and reviews claim folders and documentation pertaining to current and prior filings for claims where fraud is suspected.
  • Collects other documentation and records to develop independent evidence from a variety of sources, including state and local government offices.
  • Conducts detailed analyses and prepares or contributes to the preparation of reports of findings, recommending a course of action. Implements accepted recommendations and monitors to ensure that specific actions are taken.
  • Maintains confidential records, files, and various databases pertaining to allegations and cases under investigation.
  • Provides training to FO, DDS and OHO staff on the fraud referral process, including identifying potential fraud situations.
  • Accompanies DDS staff assigned to the CDI Unit to local DDS offices and provides technical information regarding FO policy and procedures.
  • Performs a broad range of administrative duties, including ordering/purchasing equipment and supplies and updating databases and systems storing data related to physical security of the site and SSA property onsite.

Requirements

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Conditions of employment

  • All application materials must be received by the closing date. All application forms submitted become the property of SSA Human Resources. Requests for copies of application documents will not be accepted.
  • Applicants must be in good standing. Applicants must have a fully successful rating of record. Official Personnel Folders will not be reviewed.
  • See QUALIFICATIONS and ADDITIONAL INFORMATION for important information about this position.
  • See HOW YOU WILL BE EVALUATED, REQUIRED DOCUMENTS and HOW TO APPLY for more information on submitting your application.
  • You must submit a resume (2 page maximum) that shows your name and contact information, organizational assignment and geographic location, full TO and FROM dates (month/day/year) and grade for each position you describe.
  • SSA-45s are optional and must be submitted under the Document Type “Other".

Qualifications

To meet Minimum Qualifications for this GS-12 CDI Program Specialist (Social Insurance Specialist) position you must demonstrate at least 52 weeks of Specialized Experience.

SPECIALIZED EXPERIENCE must have been gained in a federal position at or above GS-11 OR (if your position is on another federal pay scale OR outside of federal service) by performing duties at a level of responsibility and difficulty equivalent to GS-11 or above.

SPECIALIZED EXPERIENCE is work that primarily consists of the development, examination, investigation, adjudication, authorization, administration, analysis or review of claims or program actions related to retirement, survivors, disability, health insurance, pension, income-maintenance or similar benefit programs.

Experience should include one or more of the following:

  • reviewing and evaluating information to determine eligibility, entitlement, payment or other program actions
  • applying applicable laws, regulations, policies or procedures
  • communicating program information to claimants, beneficiaries, the public or other stakeholders
If you have this experience, your resume must describe, in your own words, the duties you perform that demonstrate it.

Reviewers cannot assume you perform duties you don't describe.

Since Specialized Experience also has a time component, it must be evident that the duties you describe are at the required level for at least 52 weeks.

Qualification requirements must be met by the closing date of this announcement.

Applicants for promotion must have 52 weeks at GS-11.
Time in grade requirement must be met by the closing date of this announcement.

Education

This position does not have an educational requirement.

Education cannot be used in lieu of (or in combination with) Specialized Experience to meet Minimum Qualifications.

Additional information

Excepted Service employees who are currently serving under (1) a Schedule A appointment for individuals with disabilities or (2) a time-limited appointment for 30% or more disabled veterans, who meet other eligibility and qualification requirements, may apply using current Excepted Service status in lieu of meeting the requirement for Competitive Service status. Applicants serving under these appointments should not submit disability or veteran's documents but must submit SF-50s (see REQUIRED DOCUMENTS). Veterans Preference will not be considered under this vacancy announcement.

NOTE: Excepted service employees serving under Schedule A appointments for Attorney positions or Pathways Programs appointments (Presidential Management Fellows, Recent Graduates, and Interns) are not eligible for consideration.

See block 34 of your most recent SF-50 to confirm type of service.
"1" means you should file as a competitive service employee, even if you are disabled and/or a veteran.
"2" means you should refer to the SF-50 you received when you were hired to see if your appointment-type matches one of those listed above.
If so, you should file as an eligible excepted service employee; if not, you are not eligible to apply for this position.

OTHER NOTES:

See QUALIFICATIONS for information on qualifying for this position.

See HOW YOU WILL BE EVALUATED and REQUIRED DOCUMENTS for information on applying for this position.

This is a non-bargaining unit position to be filled under the provisions of the Management Officials Promotion Plan. The best-qualified list for this vacancy may be used to fill the same or similar positions in a component(s) under the same Deputy Commissioner. Additional selections may be made within 6 months of the date the best qualified list is issued.

LOCALITY PAY: Salary will be set in accordance with locality pay provisions. Candidates currently receiving a higher locality pay than the office applied for are advised that should they be selected, they will lose entitlement to the higher locality pay.

This position is full-time, flex-time schedule: Alternate Work Schedules (AWS) may be authorized.

This position is not eligible for telework.

Relocation expenses will not be paid.

This is a moderate risk public trust position. You may be required to complete Standard Form 85P, Questionnaire for Public Trust Positions, to have the appropriate investigation conducted.

This position is assigned to:
Chief of Risk & Quality (RQ)
Cooperative Disability Investigation Support

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.

1. Eligibility will be based on your claim under the ELIGIBILITY SECTION at the beginning of the online questionnaire, in addition to your responses to Question #3 (Appointment) and Question #4 (Appraisal).

You will not receive further consideration if you:

  • do not chose an eligibility at the beginning of the online questionnaire
  • choose an incorrect eligibility at the beginning of the online questionnaire
  • provide a response that indicates you are not eligible
  • fail to provide documents to support your claim OR
  • are otherwise found ineligible during this part of the review.
Only applicants who meet eligibility requirements will be evaluated.

Your resume/SSA-45 must show your geographical location, your grade and the full TO and FROM dates (month/day/year) for each position you describe. Resumes are limited to 2 pages.

2. If rated 'eligible' you will receive a score based on your responses to the online experience questions.

Preview questionnaire here: https://apply.usastaffing.gov/ViewQuestionnaire/13064135

3. If you are among the highest- ranking applicants based on your score, your resume will be reviewed by HR to determine if you demonstrate the Specialized Experience.

RESUME/SSA-45: Describe duties you perform that meet the Specialized Experience required for this position (see QUALIFICATIONS), as well as duties that demonstrate the following as they relate to the Specialized Experience. Duties not clearly described cannot be credited.
  • Knowledge of SSA's programs, operations and policies (15 points)
  • Ability to research, compile and analyze data and make recommendations (15 points)
  • Ability to communicate effectively, orally and in writing (15 points)
Total possible points = 45 points

SEE REQUIRED DOCUMENTS for additional resume requirements.

4. The highest ranked applicants who demonstrate the Specialized Experience will be referred to the hiring manager and applicable documents will be forwarded for further review.

Your claimed knowledge, skills and abilities are subject to verification by the selecting official. You may be asked to provide specific examples or documentation or to verify a response by a practical demonstration of your claimed experience.

Social Security Administration

Creating a my Social Security (mySSA) account is a convenient way to access your personal Social Security information online. While not required for this position or the application process, you may wish to learn more about the benefits of having a mySSA account by visiting www.ssa.gov/myaccount.

Agency contact information

Rolanda Turner
Phone
215-597-1925
Email
Rolanda.Turner@ssa.gov
Address
Risk and Quality
6401 Security Blvd
Baltimore, MD 21207
US

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http://www.ssa.gov/careers/

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