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.
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. Time-in grade-restrictions: Applicants who are current or former Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements (52 weeks at the next lower 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.
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.