New job Health Insurance Specialist in California
Health Insurance Specialist
Company : US Centers for Medicare & Medicaid Services
Salary : $79,468 - $103,309 a year
Location : California
This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Clinical Standards and Quality,Northeast Survey & Enforcement Division.
As a Health Insurance Specialist, GS-0107-13, you will develop survey and certification policies and
procedures and provide national Federal oversight of thousands of health care providers and suppliers under CMS' programs.
- Develop and review health care policies and legislation in order to draft related policy documents, regulations, procedures and guidance to states.
- Develop, implement, and maintain operational requirements, including standard operating procedures, as well as databases to manage and analyzes programmatic documentation.
- Conduct oversight of these centers and facilities to ensure compliance with the regulatory requirements.
- Conduct analytical studies and evaluate the effectiveness of program initiatives by gathering, organizing, and interpreting data.
25% or less - You may be expected to travel for this position.
Job family (Series)
0107 Health Insurance Administration
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.
- Time-in-Grade restrictions apply.
QualificationsALL QUALIFICATION REQUIREMENTS MUST BE MET WITHIN 30 DAYS OF THE CLOSING DATE OF THIS ANNOUNCEMENT.
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-13, 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-12 grade level in the Federal government, obtained in either the private or public sector, to include: (1) Developing and/or implementing policies and procedures related to the regulatory requirements of health care providers/suppliers; (2) Assessing health care providers and supplier programs for adherence to health and safety standards; and (3) Providing technical guidance and oversight related to regulatory requirements of health care providers/suppliers.
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/11137735
This job does not have an education qualification requirement.
Bargaining Unit Position: Yes
Tour of Duty: Flexible
Recruitment/Relocation Incentive: Not Authorized
Financial Disclosure: Not Required
Full-Time Telework Program for CMS Employees: CMS employees currently participating in 100% Full-Time Telework Program may be eligible to remain in the program. If an employee in this program is selected, the pay will be set in accordance with the locality pay for the applicable duty station. The listed salary range reflects the locality pay assigned to the duty location(s) listed in the vacancy announcement. For more information about pay based on locality, please visit the Office of Personnel Management (OPM) Salaries & Wages Page.
Additional Forms REQUIRED Prior to Appointment:
- Optional Form 306, Declaration of Federal Employment and the Background/Suitability Investigation - A background and suitability investigation will be required for all selectees. Appointment will be subject to the successful completion of the investigation and favorable adjudication. Failure to successfully meet these requirements may be grounds for appropriate personnel action. In addition, if hired, a reinvestigation or supplemental investigation may be required at a later time. If selected, the Optional Form 306 will be required prior to final job offer. Click here to obtain a copy of the Optional Form 306.
- Form I-9, Employment Verification and the Electronic Eligibility Verification Program - CMS participates in the Electronic Employment Eligibility Verification Program (E-Verify). E-Verify helps employers determine employment eligibility of new hires and the validity of their Social Security numbers. If selected, the Form I-9 will be required at the time of in-processing. Click here for more information about E-Verify and to obtain a copy of the Form I-9.
- Standard Form 61, Appointment Affidavits - If selected, the Standard Form 61 will be required at the time of in-processing. Click here to obtain a copy of the Standard Form 61.
If you are unable to apply online or need to fax a document you do not have in electronic form, view the following link for information regarding an Alternate Application.
How You Will Be Evaluated
You will be evaluated for this job based on how well you meet the qualifications above.
Additional selections may be made for similar positions across the Department of Health and Human Services (HHS) within the local commuting area(s) of the location identified in this announcement. By applying, you agree to have your application shared with any interested selecting official(s) at HHS. Clearance of CTAP/ICTAP will be applied for similar positions across HHS.
Once the announcement has closed, your online application, resume, transcripts and CMS required documents will be used to determine if you meet eligibility and qualification requirements listed on this announcement. If you are found to be among the top qualified candidates, you will be referred to the selecting official for employment consideration. Please follow all instructions carefully. Errors or omissions may affect your rating.
Your qualifications will be evaluated on the following competencies (knowledge, skills, abilities and other characteristics):
- Compliance Inspection
- Oral Communication
- Survey and Certification
- Written Communication
Background checks and security clearance
Drug test required
Position sensitivity and risk
Non-sensitive (NS)/Low Risk
Trust determination process
The following documents are REQUIRED:
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 (mm/yyyy) of each employment along with the number of hours worked per week. For work in the Federal service, you must include the series and grade level for the position(s). Your resume will be used to validate your responses to the assessment tool(s). For resume and application tips visit: https://www.usajobs.gov/Help/faq/application/documents/resume/what-to-include/
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.
PLEASE NOTE: A complete application package includes the online application, resume, transcripts and CMS required documents. Please carefully review the full job announcement to include the "Required Documents" and "How to Apply" sections. Failure to submit the online application, resume, transcripts and CMS required documents, will result in you not being considered for employment.
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.
This job is open to
Career transition (CTAP, ICTAP, RPL)
Federal employees who meet the definition of a "surplus" or "displaced" employee.
Federal employees - Competitive service
Current or former competitive service federal employees.
Federal employees - Excepted service
Current excepted service federal employees.
Individuals with disabilities
Land & base management
Certain current or former term or temporary federal employees of a land or base management agency.
Peace Corps & AmeriCorps Vista
Individuals eligible under a special authority not listed above, but defined in the federal hiring regulations.
Clarification from the agency
OPM Interchange Agreement; OR Miscellaneous Authorities Not Regulated by U.S. Office of Personnel Management.