Medicaid Managed Care Technical Lead

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), Managed Care Group.

As a Health Insurance Specialist, referred to here as a Medicaid Managed Care Technical Lead, GS-0107-14, you will serve as a technical authority and advisor for Medicaid State Directed Payments (SDP).

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.

Interpreting and implementing federal statutes and regulations impacting Medicaid managed care to develop program guidance and ensure state compliance; 2.

Operationalizing federal regulation requirements pertaining to Medicaid managed care payment policy to ensure state compliance with federal standards; AND 3.

Providing technical direction and guidance on Medicaid managed care and payment policy to federal and state stakeholders to support program implementation and policy interpretation.

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/12893781 Major Duties:

• Serve as a technical authority and provides technical direction and leadership related to Medicaid managed care and other policy related areas.
• Lead the development and implementation for Medicaid managed care new policies and regulations.
• Serve as a technical expert on state directed payments policies and/or operations for Medicaid managed care and coordinates cross-cutting projects.
• Lead projects or studies that analyze the efficiency, effectiveness and/or outcomes of Medicaid managed care programs and conducts special assignments on a wide range of significant management, operational, and policy issues.
• Consult, advise, and brief leadership on critical policies, procedures, and issues that have a major impact on Medicaid programs.