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, Medicare Contractor Management Group (MCMG). As a Health Insurance Specialist, GS-0107-13, you will serve as a senior specialist responsible for analyzing, evaluating, and improving Medicare contractor operations, policies, and program performance.

Responsibilities

Planning, coordinating, and evaluating Medicare Administrative Contractor procurements, awards, transitions, and oversight activities to support effective administration of the Original Medicare program.

Analyzing Medicare contractor operations, policies, systems, and performance to assess compliance, identify risks and deficiencies, and recommend corrective actions and process improvements.

Developing acquisition strategies, pre-solicitation materials, Requests for Proposals, Statements of Work, technical evaluations, and related procurement documentation in collaboration with contracting and program officials.

Leading projects and providing technical guidance on Medicare contractor policy and operations by assigning work, reviewing technical products, analyzing complex issues, and presenting recommendations to management.

Serving as a liaison with CMS components, contractors, stakeholders, and other government officials to coordinate Medicare initiatives, resolve procurement and operational issues, and communicate program requirements and policy findings.

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. Administering health-related or insurance-related contracts; and2. Developing or evaluating Medicare policies or contracts; and3. Leading projects or teams related to Medicare Contract Administration. 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: https://apply.usastaffing.gov/ViewQuestionnaire/13068043