Health Insurance Specialist

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. Learn more about this agency Duties 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 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. Expand Hide  additional information 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. Benefits A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits. Review our benefits Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.