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Senior Medicare Contract Operations Specialist

Railroad Retirement Board
This job announcement has closed

Summary

This position is located in Unemployment and Programs Support. The incumbent works closely with the Medicare Contracting Officer's Representative (COR) on all Medicare related issues and studies.

This job announcement may be used to fill one or more vacancies.

This is a bargaining unit position.

Overview

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Reviewing applications
Open & closing dates
11/18/2025 to 12/02/2025
Salary
$90,025 to - $117,034 per year

This salary reflects the GS base rate and will be adjusted to include locality pay upon selection.

Pay scale & grade
GS 13
Location
1 vacancy in the following location:
Location Negotiable After Selection
Remote job
No
Telework eligible
Yes—As determined by the agency policy. THIS IS NOT A REMOTE POSITION.
Travel Required
25% or less - You may be expected to travel for this position.
Relocation expenses reimbursed
No
Appointment type
Permanent
Work schedule
Full-time
Service
Competitive
Promotion potential
13
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
250022DE-12834722-TH
Control number
850296200

Duties

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As a Senior Medicare Contract Operations Specialist, you will:

  • Assist the Medicare COR in the conducting of studies and reviews of the contractor designated to process Part B Medicare claims for the Railroad Retirement Board (RRB) to assure compliance with the contract and applicable laws and regulations.
  • Assess contractor performance and operations in order to make recommendations to improve the effectiveness of operations or otherwise assist the Medicare COR in performance of contractor monitoring.
  • Make recommendations involving renewal or termination of the contract; providing technical assistance to the contractor; and reviewing and commenting on the contractor's budget.
  • Represent the RRB in contacts with outside organizations and groups interested in the program.
  • Periodically travel to perform certain work assignments on-site at the contractor's location.
  • Serve as backup to the COR when that person is unavailable.
  • Participate in planning, directing, or coordinating the work of the lower level specialist.

Requirements

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Conditions of employment

  • Must be a U.S. Citizen
  • Males born after 12/31/59 must be registered for Selective Service
  • Suitable for Federal employment, determined by a background investigation
  • May be required to successfully complete a probationary period
  • Complete the initial online assessment and USAHire Assessment, if required

Qualifications

Minimum Qualifications for GS-13 level: One year of specialized experience equivalent to the GS-12 grade level in the Federal service. Specialized experience is experience conducting analyses, reviews, and evaluation of Medicare contractor operations, processes and procedures as they relate to Part B Medicare Claims operations. This experience must have equipped the candidate with the particular knowledge, skills and abilities to successfully perform the duties of this position.

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.

Education

There is no education substitution for this position.

Additional information

Reasonable Accommodation (RA) Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments if you received the link after the close of the announcement. To determine if you need a RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments here: https://help.usastaffing.gov/Apply/index.php?title=Reasonable_Accommodations_for_USA_Hire

INTERAGENCY CAREER TRANSITION ASSISTANCE PLAN (ICTAP):

  • ICTAP provides eligible displaced Federal competitive service employees with selection priority for competitive service vacancies. You must be determined to be well-qualified for the vacancy to be eligible for special selection priority. After submission of an acceptable application which meets ICTAP eligibility, you will be determined to be well-qualified for a vacancy if your rating places you in the best qualified category.
  • ICTAP eligibles must submit proof of eligibility for special selection priority. Please see the Required Documents section below for more information. Click here for more information on ICTAP.

If you are a male applicant who was born after 12/31/59 you are required to register under the Military Selective Service Act; the Defense Authorization Act of 1986 requires that you be registered or you are not eligible for appointment in this agency.

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.

Your qualifications will be evaluated based on your application materials (e.g., resume, supporting documents), your responses on the application questionnaire, and your responses to all assessments required for this position. You will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics):

Applicants will be rated on the following competencies:

  • Attention to Detail
  • Decision Making
  • Flexibility
  • Integrity/Honesty
  • Interpersonal Skills
  • Reading Comprehension
  • Reasoning
  • Self-Management
  • Teamwork

Overstating your qualifications and/or experience in your application materials or application questionnaire may result in your removal from consideration. Cheating on an assessment may also result in your removal from consideration.

Category rating procedures will be used to rank eligible candidates. Qualified candidates will be assigned to the following categories: Best Qualified, Qualified, and Minimally Qualified. Within each quality category, veterans' preference eligibles will receive selection priority over non-veterans.

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 quality 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 scientific or professional positions at the GS-09 level or higher).

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