Summary

This position is located in the Center for Medicare, Centers for Medicare and Medicaid Services (CMS).

As the Director, you will provide executive leadership, direction and coordination for the Provider Billing Group (PBG). The position provides executive direction to activities necessary to ensure the successful completion of planning, and implementation of program management for the operational policies and budget guidelines for claims processing in the Medicare fee-for-service (FFS) program.

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Overview

Accepting applications

Open & closing dates

04/11/2024 to 04/24/2024

Salary

$141,022 - $212,100 per year

Pay scale & grade

ES 00

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Locations

1 vacancy in the following locations

San Francisco, CA

Denver, CO

Washington, DC

Atlanta, GA

Show more locations (8)

Chicago, IL

Boston, MA

Baltimore, MD

Kansas City, MO

New York, NY

Philadelphia, PA

Dallas, TX

Seattle, WA

Remote job

Telework eligible

Yes-as determined by the agency policy.

Travel Required

Not required

Relocation expenses reimbursed

Appointment type

Permanent -

Work schedule

Full-time -

Service

Senior Executive

Promotion potential

None

Job family (Series)

0340 Program Management

Supervisory status

Yes

Security clearance

Not Required

Drug test

Position sensitivity and risk

High Risk (HR)

Trust determination process

Suitability/Fitness

Announcement number

HHS-CMS-ES-2024-12379209

Control number

786257900

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This job is open to

Senior executives

Those who meet the five Executive Core Qualifications (ECQs).

The public

U.S. Citizens, Nationals or those who owe allegiance to the U.S.

Clarification from the agency

All groups of qualified individuals

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Duties

Leads and directs the development of the requirements, methods, standards, policies, procedures, and budget guidelines for Medicare FFS claims processing related activities.

Provides operational expertise to the development and implementation of Agency policies, regulations, procedures, new payment models and legislative proposals, taking into consideration the impacts on affected stakeholders and business processes.

Coordinates modifications to existing operational procedures, contracts, and related materials, as required. Recommends alternatives to existing processes, policies, and procedures, as well as methods of improvement.

Identifies and reacts to deficiencies in Medicare FFS claims processing requirements and develops instructions and guidelines for proper claims processing, including findings identified in OIG and GAO reports.

Directs the development and release of pricing software and files used in Medicare FFS claims processing for institutional, professional and supplier claims, including Pricers, fee schedules, and coding files.

Directs the development of data analysis programs and software modules necessary to support Medicare FFS payment policy development.

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Requirements

Conditions of Employment

U.S. Citizenship required.

Background and/or Security Investigation required.

One year SES probationary period required.

The Ethics in Government Act, PL 95-521 requires the applicant selected for this position to submit a financial disclosure statement, SF-278, prior to assuming the SES position, annually, and upon termination of employment.

Status applicants must submit a copy of their most recent SF-50, Notification of Personnel Action, which verifies status.

All initial appointments to an SES position are contingent on approval from OPM's Qualifications Review Board unless the selectee has successfully participated in an OPM approved SES Candidate Development Program.

All male applicants born after December 31, 1959, must have registered for the selective service. You will be required to sign a statement certifying his registration, or the applicant must demonstrate exempt status under the Selective Service Law.

Only experience obtained by the closing date of this announcement will be considered.

Qualifications

All competitive candidates for SES positions with the Federal Government must demonstrate leadership experience indicative of senior executive level management capability. To meet the minimum qualification requirements for this position, you must show in your resume that you possess the Fundamental Competencies, five Executive Core Qualifications, and the Professional/Technical Qualifications listed below. Evidence of this experience must be incorporated into your five page resume. Separate narratives for the Executive Core Qualifications and/or Professional/Technical Qualifications will not be accepted or considered. Typically, experience of this nature is gained at or above the GS-15 grade level in the Federal service, or its equivalent with state or local government, the private sector, or nongovernmental organizations.

Fundamental Competencies

Interpersonal Skills, Oral Communication, Integrity/Honesty, Written Communication, Continual Learning, and Public Service Motivation.

Executive Core Qualifications (ECQs)

Leading Change: The ability to bring about strategic change, both within and outside the organization, to meet organizational goals. Inherent to this ECQ is the ability to establish an organizational vision and to implement it in a continuously changing environment.

Leading People: The ability to lead people toward meeting the organization's vision, mission, and goals. Inherent to this ECQ is the ability to provide an inclusive workplace that fosters the development of others, facilitates cooperation and teamwork, and supports constructive resolution of conflicts.

Results Driven: The ability to meet organizational goals and customer expectations. Inherent to this ECQ is the ability to make decisions that produce high-quality results by applying technical knowledge, analyzing problems, and calculating risks.

Business Acumen: The ability to manage human, financial, and information resources strategically.

Building Coalitions: The ability to build coalitions internally and with other Federal agencies, State and local governments, nonprofit and private sector organizations, foreign governments, or international organizations to achieve common goals.

Professional/Technical Qualifications (PTQs)

This position also requires that you possess PTQs that represent knowledge, skills, and abilities essential for success in this role. The following PTQs must be evident in your resume.

Demonstrated knowledge and leadership experience related to a large-scale health care program or entity, including the critical operational, policy, and financial forces that influence organizational results.

Demonstrated experience, in an executive leadership position, in negotiation and collaboration with a wide range of senior leaders on complex issues concerning a national/state health care program or large-scale health care entity.

Demonstrated experience in developing and managing implementation of a strategic plan for a large-scale health care program or entity.

It is STRONGLY recommended that you visit the following Office of Personnel Management (OPM) webpage for more information regarding the Fundamental Competencies and ECQs.

If selected, you will be required to complete an ECQ package by drafting narratives for each of the ECQs for submission and certification by an OPM Qualifications Review Board (QRB) in order to be placed in this position. If you are currently serving in a career SES appointment, are eligible for reinstatement into the SES, or have successfully completed an SES Candidate Development Program approved by the Office of Personnel Management (OPM), you will not need to draft the ECQs.

Education

This job does not have an education qualification requirement.

Additional information

Salary for SES positions varies depending on qualifications. The annual salary range is found at the top of this announcement. The selectee for this position may be eligible for annual performance bonuses and performance-based pay adjustments.

Veteran's Preference does not apply to the SES.

Workplace Flexibility at CMS: This position has a regular and recurring reporting requirement to the CMS office listed in this announcement; however, CMS offers flexible working arrangements and allows employees the opportunity to participate in telework combined with alternative work schedules at the manager's discretion. This position may be authorized for telework. Telework eligibility will be discussed during the interview process. Supervisory positions must report a minimum 2 times per week and non-Supervisory positions must report a minimum of 2 times per pay period.

To ensure compliance with an applicable preliminary nationwide injunction, which may be supplemented, modified, or vacated, depending on the course of ongoing litigation, the Federal Government will take no action to implement or enforce Executive Order 14043 Requiring Coronavirus Disease 2019 Vaccination for Federal Employees. Therefore, to the extent a federal job announcement includes the requirement to be fully vaccinated against COVID-19 pursuant to Executive Order 14043, that requirement does not currently apply. Positions with vaccination requirements under authority(ies) separate and distinct from Executive Order 14043 will be clearly identified. HHS may continue to require documentation of proof of vaccination to ensure compliance with those policies. Health and safety protocols remain in effect, in accordance with CDC guidance and the Safer Federal Workforce Task force. Consistent with current guidance, workplace safety protocols will no longer vary based on vaccination status or otherwise depend on the availability of vaccination information. Therefore, to the extent a job announcement states that HHS may request information regarding the vaccination status of selected applicants for the purposes of implementing workplace safety protocols, this statement does not currently apply.

Benefits

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A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.

Review our benefits

Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.

How You Will Be Evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

We use a multi-step process to evaluate and refer applicants:

Minimum requirements: Your application must show that you meet all requirements, including the education and/or experience required for this position. You may be found 'not qualified' if you do not possess the minimum competencies required for the position. If your application is incomplete, we may rate you as ineligible.

Rating: A panel of Senior Executives will review your application and evaluate your qualification for this position based on the information in your application. Your application will be rated, based on the extent and quality of your experience, education, and training relevant to the duties of this position. Interviews will be at the discretion of the panel and/or selection official.

Referral: If you are among the top qualified candidates, your application will be referred to a selection official for consideration and possible interview.

Benefits

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Review our benefits

Required Documents

As a new or existing federal employee, you and your family may have access to a range of benefits. Your benefits depend on the type of position you have - whether you're a permanent, part-time, temporary or an intermittent employee. You may be eligible for the following benefits, however, check with your agency to make sure you're eligible under their policies.

All applicants are required to submit and/or complete the following documents to be considered for the position:

Resume that contains your full name, address and phone number, and does not exceed the five page limit;

Cover Letter (optional);

Online Assessment Questionnaire. To preview the assessment questionnaire, click here:

NOTE: THE USAJOBS RESUME TEMPLATE MAY RESULT IN A RESUME BEING LONGER THAN FIVE PAGES. PLEASE VERIFY PAGE LENGTH BEFORE SUBMISSION OF APPLICATION.

Applicants who are currently, or were previously, Federal employees must also submit:

An SF-50 showing your current or former civil service status; and

Proof of OPM Qualifications Review Board certification (OPM-approved SES Candidate Development Program graduates), if applicable.

NOTE: Documents submitted that are not listed in the Required Documents section of this announcement will not be considered or forwarded to the rating panel or selecting official.

How to Apply

The application process used to recruit for this position is the RESUME BASED method. Although applicants cannot address the ECQs or PTQs separately, evidence of each must be clearly demonstrated in the five page resume and throughout the rest of the application package.

To be considered for this position, you must submit a complete application no later than 11:59 PM (Eastern Time) on the closing date of the announcement - 04/25/2024. If you fail to submit a complete application prior to the closing time, the application system will not allow you to finish. Requests for extensions will not be granted, so please begin the application process with enough time to finish before the deadline.

ALL APPLICANTS (including Commissioned Corps Officers): You must submit a resume (five-page maximum - resumes that exceed the five-page limit will not be considered). You may also submit an optional cover letter. Separate written narratives addressing the ECQs and PTQs will not be considered.

You must complete the online assessment questions. If your resume does not support the responses in your questionnaire, you may be rated "ineligible." We recommend that your resume emphasize your level of responsibilities, the scope and complexity of the programs managed, and your program accomplishments, including the results of your actions.

Your five page resume should include the following

Job Information (Announcement number and title of job for which you are applying)

Personal Information (Full name, mailing address, work and home phone number and email addresses)

Education (College/University name, city and state, major, type and year of degree)

Work Experience (Job title (including series and grade, if Federal employment, duties and accomplishments, employer's name and address, start and end dates (month and year), hours per week, and salary)

Evidence of experience which addresses the five ECQs and the PTQs.

Other qualifications (Job-related training courses (title and year), skills, certifications and licenses, honors, awards, and special accomplishments).

It is important that your resume be complete and thorough. Please be sure to include and address all ECQs and PTQs in your resume. A sample five-page resume that incorporates the ECQs can be found in OPM's Guide to Senior Executive Service Qualifications:

Steps to submit a complete application

You must have a USAJobs account and be logged in.

Once you are logged in and all of your application materials are ready, click the "Apply" button.

You must respond to all application assessment questions, carefully following the instructions provided. To preview the questions, click here:

You will then be asked to upload your resume and optional cover letter. Additional documentation not listed in the Required Documents will not be considered.

Agency contact information

Margaret Moore

Phone

000-000-0000

Margaret.moore@cms.hhs.gov

Address

Center for Medicare

7500 Security Blvd

Woodlawn, MD 21244

Learn more about this agency

Next steps

You will receive an email informing you of the receipt of your application. Applicants who are determined to be highly qualified by the SES rating panel will be referred to the selecting official for further consideration and possible interview, at which time you will be contacted. All applicants will be notified of the outcome of their applications once a final selection is made.

Fair and Transparent

The Federal hiring process is set up to be fair and transparent. Please read the following guidance.

Equal Employment Opportunity (EEO) Policy

Reasonable accommodation policy

Financial suitability

Selective Service

New employee probationary period

Signature and false statements

Privacy Act

Social security number request

Help

Required Documents

All applicants are required to submit and/or complete the following documents to be considered for the position:

Resume that contains your full name, address and phone number, and does not exceed the five page limit;

Cover Letter (optional);

Online Assessment Questionnaire. To preview the assessment questionnaire, click here:

NOTE: THE USAJOBS RESUME TEMPLATE MAY RESULT IN A RESUME BEING LONGER THAN FIVE PAGES. PLEASE VERIFY PAGE LENGTH BEFORE SUBMISSION OF APPLICATION.

Applicants who are currently, or were previously, Federal employees must also submit:

An SF-50 showing your current or former civil service status; and

Proof of OPM Qualifications Review Board certification (OPM-approved SES Candidate Development Program graduates), if applicable.

NOTE: Documents submitted that are not listed in the Required Documents section of this announcement will not be considered or forwarded to the rating panel or selecting official.

Help

How to Apply

Your five page resume should include the following

Job Information (Announcement number and title of job for which you are applying)

Personal Information (Full name, mailing address, work and home phone number and email addresses)

Education (College/University name, city and state, major, type and year of degree)

Work Experience (Job title (including series and grade, if Federal employment, duties and accomplishments, employer's name and address, start and end dates (month and year), hours per week, and salary)

Evidence of experience which addresses the five ECQs and the PTQs.

Other qualifications (Job-related training courses (title and year), skills, certifications and licenses, honors, awards, and special accomplishments).

Steps to submit a complete application

You must have a USAJobs account and be logged in.

Once you are logged in and all of your application materials are ready, click the "Apply" button.

You must respond to all application assessment questions, carefully following the instructions provided. To preview the questions, click here:

You will then be asked to upload your resume and optional cover letter. Additional documentation not listed in the Required Documents will not be considered.

Agency contact information

Margaret Moore

Phone

000-000-0000

Margaret.moore@cms.hhs.gov

Address

Center for Medicare

7500 Security Blvd

Woodlawn, MD 21244

Learn more about this agency

Next steps

Fair & Transparent

The Federal hiring process is set up to be fair and transparent. Please read the following guidance.

Equal Employment Opportunity (EEO) Policy

Reasonable accommodation policy

Financial suitability

Selective Service

New employee probationary period

Signature and false statements

Privacy Act

Social security number request

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Twitter

Help

Overview

Accepting applications

Open & closing dates

04/11/2024 to 04/24/2024

Salary

$141,022 - $212,100 per year

Pay scale & grade

ES 00

Locations

1 vacancy in the following locations

San Francisco, CA

Denver, CO

Washington, DC

Atlanta, GA

Show more locations (8)

Chicago, IL

Boston, MA

Baltimore, MD

Kansas City, MO

New York, NY

Philadelphia, PA

Dallas, TX

Seattle, WA

Remote job

Telework eligible

Yes-as determined by the agency policy.

Travel Required

Not required

Relocation expenses reimbursed

Appointment type

Permanent -

Work schedule

Full-time -

Service

Senior Executive

Promotion potential

None

Job family (Series)

0340 Program Management

Supervisory status

Yes

Security clearance

Not Required

Drug test

Position sensitivity and risk

High Risk (HR)

Trust determination process

Suitability/Fitness

Announcement number

HHS-CMS-ES-2024-12379209

Control number

786257900

This job originated on For the full announcement and to apply, visit Only resumes submitted according to the instructions on the job announcement listed at will be considered.