Health Insurance Specialist

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Program Integrity, Data Analytics and Systems Group. As a Health Insurance Specialist, GS-0107-15, you will provide authoritative strategic direction, technical leadership, and operational oversight for all FDOC lead generation activities, analytic operations, and cross-agency program integrity initiatives. 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. Using AI, machine learning, statistical modeling, or large-scale data mining tools to detect fraud, waste and abuse. 2. Evaluating the effectiveness of existing fraud detection methodologies and leading the development of new fraud detection techniques. 3. Collaborating with leadership to assess new and revised laws, regulations, and policy directives effects on program integrity initiatives. 4. Developing a variety of written products briefing documents, such, special reports, technical documentation, or issue papers to help senior management make informed program decisions. 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. #J-18808-Ljbffr