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(CM), Division of Chronic Care Management (DCCM) As a Health Insurance Specialist, GS-0107-15, you will serve as a senior operational and policy leader responsible for the strategic oversight, development, implementation, and continuous improvement of complex Medicare Fee-for-Service (FFS) payment systems. Responsibilities Supervisory and Managerial Leadership Plan, assign, evaluate, and coordinate the work of a professional staff; manage performance, resolve grievances, approve training and leave requests, and foster a productive and inclusive workplace. Serve as CMS’s National Expert in IPF/ESRD Payment Policy Lead development, analysis, and implementation of Medicare FFS payment policy; interpret regulations; propose modifications to address health care needs and system changes. Policy Development and Regulatory Work Develop, evaluate, and oversee regulations, manuals, guidelines, program instructions, and policy communications for IRF payment systems. Strategic Planning and Coordination Across CMS and HHS Advise senior leadership; coordinate clearance of policy materials; ensure alignment with CMS/HHS strategy; negotiate schedules, deliverables, and solutions to sensitive issues. Lead Correspondence, Liaison, and External Communications, Prepare briefings, regulatory language, and talking points; engage with Congress, OGC, DOJ, OIG, GAO, state agencies, and industry associations; provide expert technical assistance. 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: 1) Planning, directing, coordinating and organizing the work activities of subordinate employees; 2) Providing technical assistance or leadership to subordinates on legislation and policies related to Medicare; AND 3) Overseeing cross-organizational projects and analyses related to Medicare and Medicaid payment regulations and sub-regulatory guidance. . 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 Federal employees 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: No 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