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Posted: January 7, 2026 (8 days ago)

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Health Insurance Specialist

Centers for Medicare & Medicaid Services

Department of Health and Human Services

Recent

Location

Salary

$107,446 - $139,684

per year

Type

Closes

January 21, 2026

GS-1 Pay Grade

Base salary range: $21,996 - $27,534

Typical requirements: No experience required. High school diploma or equivalent.

Note: Actual salary includes locality pay (15-40%+ depending on location).

Job Description

Summary

This job involves advising on policies for Medicare Advantage health plans and prescription drug programs, analyzing laws and regulations, and recommending improvements to make these programs better.

You'll work with government leaders and outside groups to explain policies and handle requests.

It's a great fit for someone with years of experience in health policy analysis who enjoys solving complex issues in healthcare insurance.

Key Requirements

  • At least one year of specialized experience equivalent to GS-13 level, including technical expertise in healthcare regulation and program analysis
  • Ability to identify recommendations and solutions for improving Medicare Advantage and private health plans
  • Strong communication skills to convey health care policy and guidance to agency management and external stakeholders
  • Experience conducting regulatory and policy analysis for Medicare Advantage (Part C) and other health plans
  • Proficiency in developing regulations and program policies with options and analysis for senior stakeholders
  • Time-in-grade requirement: 52 weeks at GS-13 for current or former federal employees
  • Resume limited to 2 pages with detailed, original descriptions of relevant experience (no copying from announcement)

Full Job Description

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare, Center for Medicare, Division of Policy, Analysis and Planning.

As a Health Insurance Specialist, GS-0107-14, you will serve as technical advisor assessing legislative and regulatory statues for Medicare Advantage health and prescription drug plan policy and programs.

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) Providing technical expertise for healthcare initiatives to conduct regulation and program analysis; (2) Identifying potential recommendations and solutions to establish improvements for Medicare Advantage and private plans; (3) Communicating health care policy and guidance to key agency management and external stakeholders.

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 or former Federal employees and current or former Federal employees applying under the VEOA eligibility who hold or have held a permanent General Schedule position in the previous year 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/12859991 Major Duties:

  • Conduct regulatory and policy analysis for Medicare Advantage, Part C and other health care plans
  • Attend hearings and briefings as a liaison to justify policies, manage stakeholder requests, and provide expert program assistance.
  • Develop Medicare Advantage regulations and program policy to provide options and analysis for senior stakeholders.
  • Communicate assignments, milestones, and deadlines to the team regarding Medicare Advantage and Plan C plans.

Check your resume before applying to catch common mistakes

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Posted on USAJOBS: 1/7/2026 | Added to FreshGovJobs: 1/8/2026

Source: USAJOBS | ID: CMS-CM-26-12859991-ST