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 Outpatient Care (DOC), Hospital & Ambulatory Policy Group (HAPG).

As a Health Insurance Specialist, GS-0107-14, you will serve as technical expert on issues relating to payment methods and policies for the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) payment system.

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: Analyzing, drafting, and implementing Medicare Fee-For Service (FFS) payment policies; AND Completing projects related to Medicare payment policy development, implementation, or data analysis; AND Advising and briefing senior leadership in the payment policy decision-making process.

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/12864915 Major Duties:

• Lead projects designed to develop and implement payment policies and incentives for hospital outpatient and ASC services.
• Generate and apply new hypotheses and concepts in planning, conducting, and evaluating projects for the solution of complex hospital and ASC payment policy questions.
• Coordinate and oversee payment policy input into the operational implementation of new and revised hospital outpatient and ASC payment policies.
• Develop policy options, assess, analyze and present issues to senior Center and CMS policy makers.