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), Chronic Care Policy Group (CCPG), Division of Technical Payment Policy (DTPP).

As a Health Insurance Specialist, GS-0107-14, you will provide policy analysis and guidance on the physician self-referral law (Stark law) and its application to financial arrangements between physicians and healthcare providers.

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) Evaluating financial relationships between physicians and health care providers for compliance with the Physician Self-Referral Law (Stark law); (2) Performing policy analysis and development projects relating to the Physician Self-Referral Law; (3) Providing technical guidance on physician self-referral law to management and staff.

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/12902016 Major Duties:

• Provide technical direction on Physician Self-Referral Law (Stark Law) policy.
• Draft advisory opinions applying the physician self-referral law to complex factual issues.
• Lead teams of analysts in the analysis and settlement of self-disclosures submitted to the CMS Voluntary Self-Referral Disclosure Protocol (SRDP).
• Advise leadership on the complex matters for Medicare policies and Physician Self-Referral Law.