Health Insurance Specialist bei Department of Health and Human Services

Not Required

Duties

Interpret statute and develop Federal regulations, policy statements, and other program guidance.,Conduct analysis of policy issues and topics, research background information, the origin of laws, and the intended impact to make effective policy recommendations.,Develop, evaluate, refine and review regulations, rulings, manuals, program guidelines, program memoranda, policy letters, and/or instructions to effectively communicate and disseminate program policies related to CMS’ lines of business.,Attend meetings and conferences with CMS staff and serve as a source of background data on the basis of research performed in preparation for the meetings and conferences.,Prepare and coordinate a variety of written products, including position papers and briefing materials for senior officials to use as background information on program policy-related activities.

Qualifications

ALL QUALIFICATION REQUIREMENTS MUST BE MET BY THE CLOSING DATE OF THIS ANNOUNCEMENT. Your resume 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 receiving further consideration. In order to qualify for the GS-09, 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-07 grade level in the Federal government, obtained in either the private or public sector, to include: 1. Interpreting national health insurance program policies (i.e. Medicare, Medicaid, Marketplace) to address routine issues or procedural activities; AND 2. Assisting with the review of proposed, modified, or new legislation to assess the impact on national health insurance programs; AND 3. Gathering and analyzing information pertaining to health insurance program policies or operations to prepare reports or to present to leadership. - OR - Substitution of Education for Experience: You may substitute education for specialized experience at the GS-09 level by possessing a Master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree or LL.B. or J.D., if related to the position being filled. (TRANSCRIPT REQUIRED AT TIME OF APPLICATION) - OR - Combination of Experience and Education: Only graduate education in excess of the amount required for the GS-07 grade level may be used to qualify applicants for positions at the grade GS-09. Therefore, only education in excess of 1 full year of graduate level education may be used to combine education and experience. (TRANSCRIPT REQUIRED AT TIME OF APPLICATION) TRANSCRIPTS are required to verify satisfactory completion of the educational requirement related to substitution of education for experience and combination of experience and education. Please see "Required Documents" section below for what documentation is required at the time of application. In order to qualify for the GS-11, 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-09 grade level in the Federal government, obtained in either the private or public sector), to include: 1. Assisting with the analysis of national health insurance program policies (i.e. Medicare, Medicaid, Marketplace) issues to resolve program issues or to make recommendations; AND 2. Reviewing regulations, manuals, program guidelines, program memoranda, policy letters, and/or instructions to communicate health insurance program policies; AND 3. Preparing briefing materials, manuals, or reports for health insurance program policies. - OR - Substitution of Education for Experience: You may substitute education for specialized experience at the GS-11 level by possessing a Ph.D. or equivalent doctoral degree or 3 full years of progressively higher level graduate education leading to such a degree or equivalent doctoral degree or LL.M., if related to the position being filled. (TRANSCRIPT REQUIRED AT TIME OF APPLICATION) - OR - Combination of Experience and Education: Only graduate education in excess of the amount required for the GS-09 grade level may be used to qualify applicants for positions at the grade GS-11. Therefore, only education in excess of a master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree, may be used to combine education and experience. (TRANSCRIPT REQUIRED AT TIME OF APPLICATION) TRANSCRIPTS are required to verify satisfactory completion of the educational requirement related to substitution of education for experience and combination of experience and education. Please see "Required Documents" section below for what documentation is required at the time of application. In order to qualify for the GS-12, 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-11 grade level in the Federal government, obtained in either the private or public sector, to include: 1. Analyzing national health insurance program policies (i.e. Medicare, Medicaid, Marketplace) issues to provide technical support or to make policy recommendations; AND 2. Refining regulations, manuals, program guidelines, program memoranda, policy letters, and/or instructions to communicate health insurance program policies; AND 3. Presenting findings or recommendations based on analysis of health insurance programs. Substitution of Education for Experience: There is no substitution of education to meet the specialized experience requirement at the GS-12 grade level. Combination of Experience and Education: There is no combination of experience and education to meet the specialized experience requirement at the GS-12 grade level. 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/12815768

Other Information

Bargaining Unit Position: Yes- American Federation of Government Employees, Local 1923. 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 www.opm.gov/rif/employee_guides/career_transition.asp. Salary Information For a list of salaries by location, please go to the following link for more information: https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/2025/general-schedule/