Health Insurance Specialist

Summary

This position is located in the Department of Health & Human Services Centers for Medicare & Medicaid Services Center for Medicaid and Childrens Health Insurance Program (CHIP) Services (CMCS) State Demonstrations Group.

As a Health Insurance Specialist GSserves as CMS focal point for assistance with formulation coordination integration and implementation of all national program policies and operations relating to (CHIP) and the Basic Health Program (BHP).

Duties

• Providing oversight and technical assistance to states on Medicaid CHIP and BHP delivery systems waivers State Plan Amendments payment policies and program implementation.
• Developing analyzing interpreting and evaluating national policies regulations legislation procedures and guidance governing Medicaid CHIP BHP and related health programs.
• Reviewing state financing reimbursement eligibility benefits prescription drug third-party liability and other program policies to ensure compliance with applicable requirements.
• Coordinating with states territories tribal organizations Federal agencies stakeholders and Congressional staff to provide technical assistance resolve program issues and support policy implementation.
• Conducting program analyses studies data reviews and evaluations to assess program performance policy impacts financial operations integrity risks and opportunities to improve care and reduce costs.

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-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:

1. Developing or implementing policies at the state or national level for Medicaid CHIP or other similarly scaled health services program; AND
2. Providing technical assistance on health policy and health program compliance and/or cost issues AND
3. Drafting a variety of technical documents (i.e. health program policy issue and decision papers and terms and conditions or other legal documents).

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.

Click the following link to view the occupational questionnaire: This job does not have an education qualification requirement.

Additional information

Bargaining Unit Position: Yes
Tour of Duty: Flexible
Recruitment Incentive: Not Authorized
Relocation Incentive: Not Aurthorized
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:

IC