Supervisory 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), Technology, Coding, & Pricing Group (TCPG), Division of Data Analysis and Market Based Pricing (DDAMBP).

As a Supervisory Health Insurance Specialist, GS-0107-15, you will direct data analysis across HHS agencies, and be responsible for driving clinical diagnostic laboratory data analysis and data collection.

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-15, 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-14 grade level in the Federal government, obtained in either the private or public sector, to include: 1.

Leading the analysis of health care and laboratory data to advise leadership on Medicare policy, medical product safety, emergency response, or fraud prevention. 2.

Managing processes for collecting and reporting data related to Medicare Part B drugs, clinical lab services, or ambulance services to support accurate lab payments; AND 3.

Creating data tools that track the real-time impact of Medicare payment policy changes to guide program-wide rulemaking.

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/12863606 Major Duties:

• Plan work to be accomplished by subordinates, sets and adjusts short-term priorities, and prepares schedules for completion of work. Assign work to subordinates based on priorities and the capabilities of employees.
• Serve as the methodologist and public-facing lead in regard to data collection, aggregation, and analyses of pricing for clinical laboratory diagnostic testing from over 60,000 laboratories.
• Develop data analyses from Medicare claims in support of prosecutorial actions intended to recoup monies lost to waste, fraud, and abuse of the Medicare trust funds.
• Brief senior leadership in various capacities across the Federal government and will be seen as an agency expert on Medicare claims analysis.
• Direct project teams to ensure project management, quality management, performance, risk/issue management are integrated within the program and closely followed.