Health Insurance Specialist

Summary 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), Policy & Programs Group (PPG). As a Health Insurance Specialist, GS-0107-15, you will serve as the non-supervisory leader on Medicare Physician Fee Schedule (PFS), the Quality Payment Program (QPP), the Merit-based Incentive Payment System (MIPS), and Advanced Alternative Payment Models (APMs). Responsibilities Serve as the Center senior non-supervisory technical authority for PPG and CMMI on PFS, QPP, MIPS, and Advanced APM issues affecting CMMI physician payment models and the agency's transition to value-based care. Lead policy development (subject to review by for CMMI and CMS leadership) on complex business, operational, policy, regulatory, and legal issues. Provide non-supervisory senior technical authority and leadership for cross-Center collaboration on mission criticalPFS, QPP, MIPS, Advanced APM, and physician payment issues. Chair senior technical meetings, workgroups, and briefings. Requirements Conditions of Employment Qualifications ALL QUALIFICATION REQUIREMENTS MUST BE MET WITHIN 30 DAYS OF 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-15, 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-14 grade level in the Federal government, obtained in either the private or public sector, to include: Leading cross-Center collaboration or projects to identify and resolve payment model issues; AND Advising senior leadership on payment model methodologies, regulatory policies, data and claims operations, and/or program integrity; AND Facilitating or presenting information to stakeholders (e.g.,senior leadership, Congress, Office of Management and Budget (OMB), or private sector organizations) on payment model operations, risks, feasibility, or policy alignment. 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. Time-in-Grade: To be eligible, current or former Federal employees and current or former Federal employees applying under the VEOA eligibility who hold or have held a permanent General Schedule position in the previous year must have served at least 52 weeks (one year) at the next lower grade level from the position/grade level(s) to which they are applying. Click the following link to view the occupational questionnaire: Education Additional Information 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