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 and Medicaid Innovation(CMMI), State and Population Health Group (SPHG), Division of Multi-Payer Models (DMPM).

As a Supervisory Health Insurance Specialist, GS-0107-15, you will monitor the ongoing operation of models in the testing phase, including application processes, contractor and participating provider performance, payment, and data exchange.

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) Designing, developing, or managing projects or studies related to improving healthcare payment or delivery systems; AND (2) Serving as liaison to senior state officials, senior federal officials, or senior executives of other healthcare organizations; AND (3) Planning or directing the work activities of staff or teams.

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/12892920 Major Duties:

• Direct the work of health insurance specialists, social science research analysts, public health analysts, management analysts, program analysts, and program managers.
• Establish goals based on periodic evaluations and department, agency, Center, and group strategic plans.
• Work with model participants to implement model concepts, evaluating performance during model reviews, adjusting model concepts based on performance, and assessing the opportunity for certification (i.e., expanding the model in duration and scope).
• Engage with states on their overall strategy for health care delivery system reform, including for Medicare, Medicaid, dual-eligible, and commercial beneficiaries.
• Build relationships and collaborate closely with other leaders in the CMS Innovation Center, CMS, and HHS, as well as other internal and external stakeholders and organizations on key aspects of payment models.