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 Medicaid and CHIP Services (CMCS).

As a Health Insurance Specialist, GS-0107-13, you will serve as an expert in the development, evaluation, and implementation of policies related to Medicaid, Children's Health Insurance Program (CHIP), and Basic Health Program (BHP) policies.

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) Implementing program policies related to Medicaid, CHIP, or the Basic Health Program to ensure compliance with federal regulations and program objectives; 2) Developing regulations, manuals, program guidelines, program memoranda, policy letters, or instructions to communicate health insurance program policies; AND 3) Presenting recommendations based on the evaluation of health insurance programs that describe feasible options or the consequences.

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/12900705 Major Duties:

• Identify and propose modifications to Medicaid, CHIP, and BHP program measures, regulations, laws, and policies to reflect changes or trends in the health care industry, program objectives, and the needs of Medicaid, CHIP, and BHP beneficiaries.
• Conduct analysis of policy issues and topics by researching background information, the origin of laws, and the intended impact to make effective policy recommendations
• Evaluate and analyze the impact of new or revised changes to legislation before the Congress pertaining to mentioned programs.
• Research all program issues and develop the appropriate response that includes CMS regulations, or policy issuances.
• Analyze internal policies, processes, and procedures to assure increased efficiency in operations and implements them to resolve problems and improve internal operations.