Health Insurance Specialist (Technical Advisor)

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 Encounter Data & Risk Adjustment Operations (DEDRAO).

As a Health Insurance Specialist (Technical Advisor), GS-0107-14, you will provide technical direction and leadership to a highly technical professional staff; perform analysis on cross-cutting data issues and operations; and develop innovative research strategy techniques.

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.

Analyzing, developing, or implementing program operations including system updates and data collection related to payment policies and regulations involving encounter data; 2.

Preparing briefing materials and presenting to senior leadership or stakeholders related to public health insurance programs (i.e., talking points, briefing materials, fact sheets, etc.); 3.

Collaborating with leadership or internal/external stakeholders regarding program updates, program operations, or efficiencies; AND 4.

Evaluating data to make recommendations on process improvement, overall program effectiveness, and contract management.

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/12907245 Major Duties:

• Serve as program lead on issues and operational implementation related to public health insurance programs.
• Conduct data analysis on issues related to public health insurance programs, coordinating cross-cutting projects, and providing contractor oversight.
• Lead stakeholder communications, drafting technical documentation, and mentoring staff.
• Advise senior officials on payment operations and policy while representing leadership in high-level meetings with government and industry representatives.