HEALTH INSURANCE SPECIALIST

Full Job Description

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare (CM), Division of Data Assessment and Analytics (DDAA).

As a HEALTH INSURANCE SPECIALIST, GS-0107-14, you will provide technical direction and leadership to a highly technical professional staff; develop innovative and strategic operational techniques; implement complex data collection efforts, independently or in leading and directing assigned staff.

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-14, 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-13 grade level in the Federal government, obtained in either the private or public sector, to include: 1) Overseeing clinical and pharmacoeconomic data analysis and research for major healthcare and insurance programs; 2) Providing technical leadership in drug pricing and payment reform, quality development and measurement, and data and technology analysis research; AND 3) Implementing legislative changes and developing data analysis approaches to support alternative and emerging approaches.

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.

Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/12873223 Major Duties:

• Health Insurance Specialist responsible for providing technical expertise, guidance, and support on drug rebate and negotiation operational activities related to the Inflation Reduction Act of 2022.
• Review and assesses programs, operations, systems, budgets, procurement and contracting processes, business requirements for these programs and related projects determined to be of high priority in CM and CMS that have an impact on the workload.
• Advise high-level decision makers and management officials regarding drug negotiation and inflation rebate functional operations, programmatic strategic planning, and special projects.