Summary
This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicaid and CHIP Services (CMCS), Managed Care Group (MCG).
As a Health Insurance Specialist, GS-0107-13, you will focus on developing, evaluating, and implementing CMS Managed Care policies. In this role, you will be leading and participating in projects to enhance the division's efficiency and effectiveness.
Learn more about this agency
Duties
Conditions of Employment
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-13, 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-12 grade level in the Federal government, obtained in either the private or public sector, to include:
Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/12512348
Education
This job does not have an education qualification requirement.
Additional Information
Bargaining Unit Position: Yes-American Federation of Government Employees, Local 1923
Tour of Duty: Flexible
Recruitment/Relocation Incentive: Not Authorized
Financial Disclosure: Not Required
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 .
Read more
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.
How You Will Be Evaluated
You will be evaluated for this job based on how well you meet the qualifications above.
If You Meet The Minimum Qualifications And Education Requirements For This Position, Your Application And Responses To The Online Occupational Questionnaire Will Be Evaluated Under Category Rating And Selection Procedures For Placement In One Of The Following Categories:
Once the announcement has closed, your online application, resume, and CMS required documents will be used to determine if you meet eligibility and qualification requirements listed on this announcement. If you are found to be among the top qualified candidates, you will be referred to the selecting official for employment consideration. Please follow all instructions carefully. Errors or omissions may affect your rating.
Your qualifications will be evaluated on the following competencies (knowledge, skills, abilities and other characteristics):
This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicaid and CHIP Services (CMCS), Managed Care Group (MCG).
As a Health Insurance Specialist, GS-0107-13, you will focus on developing, evaluating, and implementing CMS Managed Care policies. In this role, you will be leading and participating in projects to enhance the division's efficiency and effectiveness.
Learn more about this agency
Duties
- Establishes Medicaid policy related to Medicaid Managed Care programs and other policy areas of responsibility that are located within the division.
- Advises on evaluating proposed new legislation and regulations to assess their impact on Medicaid prescription drug programs and Managed Care policies to enhance program operations and beneficiary services.
- Performs independent analyses of Medicaid Managed Care programs and other policy areas to address issues affecting the effective management of Medicaid programs.
- Processes and reviews state managed care program reports, network adequacy, and mental health parity documentation to ensure compliance with federal rules and requirements for Medicaid Managed Care plans.
- Coordinates program assignments with internal and external stakeholders as required to diagnose problems and develop viable courses of action.
- Provides specific and detailed information regarding operational policy and instructions for Medicaid Managed Care programs and policy or other policy areas of responsibility that are located within the division.
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.
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-13, 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-12 grade level in the Federal government, obtained in either the private or public sector, to include:
- Develop or implement Managed care program or similar national healthcare program policies; AND
- Implement operational procedure development to ensure regulations compliance; AND
- Provide technical assistance to ensure delivery of quality health care services.
Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/12512348
Education
This job does not have an education qualification requirement.
Additional Information
Bargaining Unit Position: Yes-American Federation of Government Employees, Local 1923
Tour of Duty: Flexible
Recruitment/Relocation Incentive: Not Authorized
Financial Disclosure: Not Required
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 .
Read more
- Help
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.
How You Will Be Evaluated
You will be evaluated for this job based on how well you meet the qualifications above.
If You Meet The Minimum Qualifications And Education Requirements For This Position, Your Application And Responses To The Online Occupational Questionnaire Will Be Evaluated Under Category Rating And Selection Procedures For Placement In One Of The Following Categories:
- Best Qualified - for those who are superior in the evaluation criteria
- Well Qualified - for those who excel in the evaluation criteria
- Qualified - for those who only meet the minimum qualification requirements
Once the announcement has closed, your online application, resume, and CMS required documents will be used to determine if you meet eligibility and qualification requirements listed on this announcement. If you are found to be among the top qualified candidates, you will be referred to the selecting official for employment consideration. Please follow all instructions carefully. Errors or omissions may affect your rating.
Your qualifications will be evaluated on the following competencies (knowledge, skills, abilities and other characteristics):
- Health Insurance
- Oral Communication
- Reasoning
- Written Communication