This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid Innovation(CMMI), Patient Care Models Group (PCMG). As a Health Insurance Specialist (Program Policy), GS-0107-12, you will perform program policy work related to national health insurance programs, such as Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and Marketplace Exchange/private health insurance.
ALL QUALIFICATION REQUIREMENTS MUST BE MET BY THE CLOSING DATE OF THIS ANNOUNCEMENT. Your resume 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 receiving further consideration. 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) Proposing, developing, or revising existing operational processes used in the design, implementation, or oversight of health care payment or service delivery models; AND 2) Preparing position papers, briefing materials, or reports based on analysis of health care program policies; AND 3) Analyzing national and/or state health insurance policies to make recommendations for improvements of new payment or service delivery models. 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 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/12786816
Interpret statute and develop Federal regulations, policy statements, and other program guidance.
Conduct analysis of policy issues and topics, research background information, the origin of laws, and the intended impact in order to make effective policy recommendations.
Develop, evaluate, refine, and review regulations, rulings, manuals, program guidelines, program memoranda, policy letters, and/or instructions to effectively communicate and disseminate program policies related to CMS’ lines of business.
Identify and develop recommendations to resolve program issues.
Attend meetings and conferences with CMS staff and serve as a source of background data on the basis of research performed in preparation for the meetings and conferences.