Health Insurance Specialist (Data Analysis and Studies)

Summary

This position is located in the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) Offices of Hearings and Inquiries.

As a Health Insurance Specialist (Data Analysis and Studies) GS/12 you will perform analytical duties related to national health insurance programs such as Medicare Medicaid the Childrens Health Insurance Program (CHIP) Marketplace Exchange/private health insurance.

Duties

• Conducting analysis of policy issues researching background information and laws and assessing intended impacts to develop effective policy recommendations.
• Validating data for accuracy and completeness and refining data into formats for individual responses or summary reports.
• Collaborating with CMS staff and stakeholders to develop innovative methods for determining and assuring the reliability and validity of productivity and workload data.

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 Selective Service -
• 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-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. Analyzing data related to national health insurance programs such as Medicare Medicaid CHIP or the Marketplace Exchange to identify trends patterns or risks affecting program operations;
2. Combining data from multiple health insurance program systems to build a reliable dataset for analysis;
3. Creating reports and visual displays from data to communicate findings to managers and staff; and
4. Utilizing data analysis tools to build dashboards and fix data quality issues.

- 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 grades GS-11. Therefore only education in excess of a masters 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 the substitution of education for experience and the combination of experience and education. Please refer to the Required Documents section below for the documentation 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. Leading the analysis of data related to national health insurance programs such as Medicare Medicaid CHIP or the Marketplace Exchange to identify significant trends or risks that shape program strategy or policy;
2. Designing data pipelines that integrate data from multiple health insurance program systems to produce analysis-ready datasets supporting program evaluation;
3. Developing dashboards and reports on Medicare Medicaid CHIP or Marketplace program data to inform senior leadership decisions; and
4. Advising senior management with data-driven recommendations on health insurance program operations policy or compliance issues to support program improvements.

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.

Education

TRANSCRIPTS are required to verify satisfactory completion of the educational requirement listed above. Please refer to the Required Documents section below for the documentation required at the time of application.

Click the following link to view the occupational questionnaire: information

Bargaining Unit Position: Yes
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 managers 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 OPMs Career Transition Resources website at 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.

Required Experience:

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