HEALTH INSURANCE SPECIALIST
Expired Job Description :Duties
- Analyze and interpret Federal regulations, policy statements, and other program guidance. Propose policy modifications to reflect changes or trends in the health care industry, program objectives and the needs of beneficiaries
- Review, evaluate, and develop Medicaid, CHIP, Basic Health Insurance Program (BHP), or the private health insurance program policy subject issues for consideration by senior management.
- Develop and review policy issues and drafting policy documents, regulations, procedures, Medicaid State Agency (SA) policy, or the private health insurance operating instruction and related documents.
- Work with States and other key stakeholders, to identify and address evolving program issues or to provide guidance on programmatic matters.
Requirements
Conditions of Employment
- You must be a U.S. Citizen or National to apply for this position.
- You will be subject to a background and suitability investigation.
- This is a remote position however, the position reports to a CMS Office on a periodic basis. Requirements to report to the office will vary and can be discussed at the time of interview.
Qualifications
Your resume 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 receiving further consideration.
In order to qualify for the GS-11, 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-09 grade level in the Federal government, obtained in either the private or public sector), to include: (1) Assisting with the analysis of national health insurance program policy in order to make recommendations (2) Assisting with the reviewing regulations, manuals, program guidelines, program memoranda, policy letters, or instructions to make recommendations regarding health insurance program policies AND (3) Working with stakeholders to make recommendations to resolve program issues.
– OR –
Substitution of Education for Experience: You may substitute education for specialized experience at the GS-11 level by possessing a Ph.D. or equivalent doctoral degree or 3 full years of progressively higher level graduate education leading to such a degree or equivalent doctoral degree or LL.M., if related to the position being filled.
– OR –
Combination of Experience and Education: Only graduate education in excess of the amount required for the GS-09 grade level may be used to qualify applicants for positions at the grade GS-11. Therefore, only education in excess of a masters or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree, may be used to combine education and experience.
TRANSCRIPTS are required to verify satisfactory completion of the educational requirement related to substitution of education for experience and combination of experience and education. Please see Required Documents section below for what documentation is required at the time of application.
In order to qualify for the GS-12, 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-11 grade level in the Federal government, obtained in either the private or public sector, to include: (1) Analyzing national health insurance program policy issues in order to make policy recommendations (2) Reviewing regulations, manuals, program guidelines, program memoranda, policy letters, or instructions to communicate health insurance program policies AND (3) Working with stakeholders to identify and resolve program issues.
Substitution of Education for Experience: There is no substitution of education to meet the specialized experience requirement at the GS-12 grade level.
Combination of Experience and Education: There is no combination of experience and education to meet the specialized experience requirement at the GS-12 grade level.
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.
Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/12025011
Additional information
Bargaining Unit Position: Yes- American Federation of Government Employees, Local 1923
Tour of Duty: Flexible
Recruitment/Relocation Incentive: Not Authorized
Financial Disclosure: Not Required
To ensure compliance with an applicable preliminary nationwide injunction, which may be supplemented, modified, or vacated, depending on the course of ongoing litigation, the Federal Government will take no action to implement or enforce Executive Order 14043 Requiring Coronavirus Disease 2019 Vaccination for Federal Employees. Therefore, to the extent a federal job announcement includes the requirement to be fully vaccinated against COVID-19 pursuant to Executive Order 14043, that requirement does not currently apply. Positions with vaccination requirements under authority(ies) separate and distinct from Executive Order 14043 will be clearly identified. HHS may continue to require documentation of proof of vaccination to ensure compliance with those policies. Health and safety protocols remain in effect, in accordance with CDC guidance and the Safer Federal Workforce Task force. Consistent with current guidance, workplace safety protocols will no longer vary based on vaccination status or otherwise depend on the availability of vaccination information. Therefore, to the extent a job announcement states that HHS may request information regarding the vaccination status of selected applicants for the purposes of implementing workplace safety protocols, this statement does not currently apply.
Remote-Out Positions at CMS: This is a remote position however, the position reports to a CMS Office on a periodic basis (e.g. 1-2 times per year). Requirements to report to the office will vary and can be discussed at the time of interview. As such, your pay will be based on your home address. For more information on locality and pay scales, please visit here. Your worksite must be within the United States and you must adhere to all regulations and policies regarding remote work at CMS and in the federal government, including the signing of a remote work agreement.
The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced federal employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit the required documentation and be rated well-qualified for this vacancy. Click here for a detailed description of the required supporting documents. A well-qualified applicant is one whose knowledge, skills and abilities clearly exceed the minimum qualification requirements of the position. Additional information about ICTAP and CTAP eligibility is on OPMs Career Transition Resources website at www.opm.gov/rif/employee_guides/career_transition.asp.
Benefits
A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
Review our benefits
Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.
How You Will Be Evaluated
You will be evaluated for this job based on how well you meet the qualifications above.
You will be evaluated based on how well you meet the qualifications listed in this vacancy announcement. Your qualifications will be evaluated based on your application materials (e.g., resume, supporting documents), the responses you provide on the application questionnaire, and the result of the online assessments required for this position. Please follow all instructions carefully. Errors or omissions may affect your rating.
You will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics):
- Attention to Detail
- Customer Service
- Decision Making
- Flexibility
- Health Insurance
- Integrity/Honesty
- Interpersonal Skills
- Oral Communication
- Policy Analysis
- Reading Comprehension
- Self-Management
- Stress Tolerance
- Teamwork
- Written Communication
- Decision Making
- Arithmetic
- Mathematical Reasoning
- Reading
- Reasoning
In order to be considered for this position, you must complete all required steps in the process. In addition to the application and application questionnaire, this position requires an online assessment. The online assessment measures critical general competencies required to perform the job.
Overstating your qualifications and/or experience in your application materials or application questionnaire may result in your removal from consideration. Cheating on the online assessment may also result in your removal from consideration.
You will be placed in one of the following categories based on category rating and selection procedures if you meet all of the requirements outlined in this job opportunity announcement:
- Best Qualified – for those who are superior in the evaluation criteria
- Well Qualified – for those who excel in the evaluation criteria
- Qualified – for those who only meet the minimum qualification requirements
If you are found to be among the top qualified candidates, you will be referred to the selecting official for employment consideration.
This is a competitive vacancy announcement advertised under Delegated Examining Authority. Selections made under this vacancy announcement will be processed as new appointments to the civil service. Current civil service employees would therefore be given new appointments to the civil service however, benefits, time served and all other Federal entitlements would remain the same.
The category rating process does not add veterans preference points or apply the rule of three but protects the rights of veterans by placing them ahead of non-preference eligibles within each category. Veterans preference eligibles who meet the minimum qualification requirements and who have a compensable service-connected disability of at least 10 percent will be listed in the highest quality category (except in the case of professional or scientific positions at the GS-09 level or higher).
Benefits
A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
Review our benefits
Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.
Required Documents
As a new or existing federal employee, you and your family may have access to a range of benefits. Your benefits depend on the type of position you have – whether youre a permanent, part-time, temporary or an intermittent employee. You may be eligible for the following benefits, however, check with your agency to make sure youre eligible under their policies.
To apply for this position, you must submit a complete Application Package which includes:
1. Resume showing relevant experience cover letter optional. Your resume must indicate your citizenship and if you are registered for Selective Service if you are a male born after 12/31/59. Your resume must also list your work experience and education (if applicable) including the start and end dates. For work in the Federal service, you must include the series and grade level for the position(s). For resume and application tips visit: https://www.usajobs.gov/Help/faq/application/documents/resume/what-to-include/.
Your resume will be used to validate your responses to the assessment tool(s). We strongly encourage applicants to utilize the USAJOBS resume builder in the creation of resumes. Determining length of general or specialized experience is dependent on the information provided in the resume. Failure to include ALL of the information listed below on your resume WILL result in a finding of ineligible.- Official Position Title (include series and grade if Federal job)
- Duties (be specific in describing your duties)
- Employers name and address
- Supervisor name and phone number
- Start and end dates in the month and year format (e.g. June 2007 to April 2008)
- Full-time or part-time status (include hours worked per week)
- Salary
2. CMS Required Documents (e.g., SF-50, DD-214, SF-15, etc.). Required documents may be necessary to be considered for this vacancy announcement. Click here for a detailed description of the required documents. Failure to provide the required documentation WILL result in an ineligible rating OR non-consideration.
3. College Transcripts. Although this position does not require a degree, you may substitute college credit in whole, or in part, for experience at specified grade levels. You must submit a copy of your transcript at the time of application in order to substitute your education for the required experience. If you do not submit a transcript, your education will not be considered in determining your qualifications for the position. You may submit an unofficial transcript or a list of college courses completed indicating course title, credit hours, and grades received. An official transcript is required if you are selected for the position.
College Transcripts and Foreign Education: Applicants who have completed part or all of their education outside of the U.S. must have their foreign education evaluated by an accredited organization to ensure that the foreign education is comparable to education received in accredited educational institutions in the U.S. For a listing of services that can perform this evaluation, visit the National Association of Credential Evaluation Services website. This list, which may not be all inclusive, is for informational purposes only and does not imply any endorsement of any specific agency.
4. Reasonable Accommodation Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments, if you received the link after the close of the announcement. To determine if you need a RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments here: https://help.usastaffing.gov/Apply/index.php?title=Reasonable_Accommodations_for_USA_HireIf you are relying on your education to meet qualification requirements:
Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education.
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
How to Apply
Please read the entire announcement and all the instructions before you begin an application. To apply for this position, you must complete the initial online application, to include the initial online assessment and submission of the required documentation specified in the Required Documents section. The complete application package must be submitted by 11:59 PM (ET) on 07/14/2023 of the announcement to receive consideration. The application process is as follows:
- To begin the application process, click the Apply button. You will need to be logged into your USAJOBS account to apply. If you do not have a USAJOBS account, you will need to create one before beginning the application.
- Follow the system prompts in USAJOBS to select your resume and supporting documents review your application package include personal information and continue the application process in the USA Staffing agency site.
- Answer the questions presented in the online application and attach all necessary supporting documentation in USA Staffing.
- Click the Submit Application button prior to 11:59PM (ET) on 07/14/2023.
- After submitting an online application, you will be notified whether or not you are required to take additional online assessments through the USA Hire Competency Based Assessment system. This message will be delivered to you via email notification. The email may be routed to your Spam or Junk folder.
- If you are asked to take the USA Hire Competency Based Assessments, you will be presented with a unique URL to access the USA Hire system. Access to USA Hire is granted through your USAJOBS login credentials. Be sure to review all instructions prior to beginning your USA Hire Assessments. Click here for Computer System Requirements.
- Note, set aside at least 3 hours to take these assessments however, most applicants complete the assessments in less time. If you need to stop the assessments and continue at a later time, you can re-use the URL sent to you via email and also found by clicking the Track This Application link located in the application record in your USAJOBS account.
To update your application, including supporting documentation, at any time during the announcement open period, return to your USAJOBS account (https://my.usajobs.gov/Account/Login). There you will find a record of your application, the application status, and an option to Edit My Application. This option will no longer be available once the announcement has closed.
To verify the status of your application both during and after the announcement open period, log into your USAJOBS account: https://my.usajobs.gov/Account/Login. All of your applications will appear on the Welcome page. The application record in your USAJOBS account contains a Track This Application link that provides information regarding the documentation you submitted and any correspondence we have sent related to this application, including the invitation to take the USA Hire assessment. The Application Status will appear along with the date your application was last updated. For information on what each Application Status means, visit: https://www.usajobs.gov/Help/how-to/application/status/.
Commissioned Corps Officers (including Commissioned Corps applicants that are professionally boarded) who are interested in applying for this position must send their professional resume (not PHS Curriculum Vitae) and cover letter to CMSCorpsJobs@cms.hhs.gov in lieu of applying through this announcement. The cover letter should specifically explain how you are qualified for this position and draw specific attention to your resume that demonstrates these qualifications. Also send any transcripts, licenses or certifications as requested in this announcement. Please send all documents in 1 PDF file. In the subject line of your e-mail please include only the Job Announcement Number. In the body of your e-mail please include your current rank name and serial number. Failure to provide this information may impact your consideration for this position.
Additional selections may be made from this announcement for similar positions within CMS with the same remote/telework designation and same geographical location, if applicable. For example, for Woodlawn, MD vacancies the same geographical location includes Baltimore, Maryland Bethesda, Maryland and Washington, D.C.Agency contact information
CMS HR Inquiries
Email
hrinquiries@cms.hhs.gov
Address
Center for Medicaid and CHIP Services
7500 Security Blvd
Woodlawn, MD 21244
USNext steps
Based on your application and your responses to the application questionnaire, you may be presented with instructions on how to access the USA Hire system to complete the online assessments. The online assessments must be completed within 48 hours following the close of this announcement. You will have the opportunity to request a testing accommodation for the assessment should you have a disability covered under the Americans with Disabilities Act (ADA).
Your assessment results will be kept on record for one year and used toward future positions for which you might apply that require the same assessments.
Fair and Transparent
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
- Equal Employment Opportunity (EEO) Policy
- Reasonable accommodation policy
- Financial suitability
- Selective Service
- New employee probationary period
- Signature and false statements
- Privacy Act
- Social security number request
Required Documents
To apply for this position, you must submit a complete Application Package which includes:
1. Resume showing relevant experience cover letter optional. Your resume must indicate your citizenship and if you are registered for Selective Service if you are a male born after 12/31/59. Your resume must also list your work experience and education (if applicable) including the start and end dates. For work in the Federal service, you must include the series and grade level for the position(s). For resume and application tips visit: https://www.usajobs.gov/Help/faq/application/documents/resume/what-to-include/.
Your resume will be used to validate your responses to the assessment tool(s). We strongly encourage applicants to utilize the USAJOBS resume builder in the creation of resumes. Determining length of general or specialized experience is dependent on the information provided in the resume. Failure to include ALL of the information listed below on your resume WILL result in a finding of ineligible.
- Official Position Title (include series and grade if Federal job)
- Duties (be specific in describing your duties)
- Employers name and address
- Supervisor name and phone number
- Start and end dates in the month and year format (e.g. June 2007 to April 2008)
- Full-time or part-time status (include hours worked per week)
- Salary
2. CMS Required Documents (e.g., SF-50, DD-214, SF-15, etc.). Required documents may be necessary to be considered for this vacancy announcement. Click here for a detailed description of the required documents. Failure to provide the required documentation WILL result in an ineligible rating OR non-consideration.
3. College Transcripts. Although this position does not require a degree, you may substitute college credit in whole, or in part, for experience at specified grade levels. You must submit a copy of your transcript at the time of application in order to substitute your education for the required experience. If you do not submit a transcript, your education will not be considered in determining your qualifications for the position. You may submit an unofficial transcript or a list of college courses completed indicating course title, credit hours, and grades received. An official transcript is required if you are selected for the position.
College Transcripts and Foreign Education: Applicants who have completed part or all of their education outside of the U.S. must have their foreign education evaluated by an accredited organization to ensure that the foreign education is comparable to education received in accredited educational institutions in the U.S. For a listing of services that can perform this evaluation, visit the National Association of Credential Evaluation Services website. This list, which may not be all inclusive, is for informational purposes only and does not imply any endorsement of any specific agency.
4. Reasonable Accommodation Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments, if you received the link after the close of the announcement. To determine if you need a RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments here: https://help.usastaffing.gov/Apply/index.php?title=Reasonable_Accommodations_for_USA_Hire
If you are relying on your education to meet qualification requirements:
Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education.
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
This job is open to
-
Career transition (CTAP, ICTAP, RPL)
Federal employees who meet the definition of a surplus or displaced employee.
-
The public
U.S. Citizens, Nationals or those who owe allegiance to the U.S.
