Duties

Summary

As the Director, Technology, Coding and Pricing Group, you will provide executive direction for the consideration of new technologies and their treatment in the Medicare program. You will lead the development and evaluation of national Medicare policies and standards on certain benefit structures and payment methods; the maintenance of medical coding systems; and the assessment of applications for special payment consideration for new technologies under several payment systems.
Learn more about this agency

Responsibilities

• Develop and evaluate national Medicare policies and principles for payment of new technologies for various provider types under prospective payment systems.
• Develop methodologies to adjust payments based on statutory and regulatory criteria.
• Develop, evaluate and review payment and benefits policies, regulations and instructions concerning durable medical equipment, prosthetics, orthotics and supplies items and services.
• Develop, evaluate and review policies, regulations, requests for codes, and instructions concerning HCPCS and ICD-10 coding.
• Develop, evaluate and issue data collection methods for clinical laboratory services and part B drug average sales price (ASP). Calculate payment amounts based on the collected data as required by regulation and statute.
• Oversee ambulance payment policy and required cost data collection for ground ambulance providers and suppliers.
• Oversee the data analysis contract used to monitor DMEPOS competitive bidding and other payment system assessment topics to support ongoing policy changes and monitor the impact of such changes.
• Maintain continuing liaison with provider groups, industry associations, patient organizations, medical associations, and other stakeholders that relate to Medicare benefits.
• Evaluate applications for new technology payment status under the inpatient and outpatient hospital prospective payment systems and the End Stage Renal Disease prospective payment system.

Travel Required

Not required

Supervisory status
Yes

Promotion Potential
None

Requirements

Conditions of Employment

• U.S. Citizenship required.
• Background and/or Security Investigation required.
• One year SES probationary period required.
• The Ethics in Government Act, PL 95-521 requires the applicant selected for this position to submit a financial disclosure statement, SF-278, prior to assuming the SES position, annually, and upon termination of employment.
• Status applicants must submit a copy of their most recent SF-50, Notification of Personnel Action, which verifies status.
• All initial appointments to an SES position are contingent on approval from OPM's Qualifications Review Board unless the selectee has successfully participated in an OPM approved SES Candidate Development Program.
• All male applicants born after December 31, 1959, must have registered for the selective service. You will be required to sign a statement certifying his registration, or the applicant must demonstrate exempt status under the Selective Service Law.
• Only experience obtained by the closing date of this announcement will be considered.

Qualifications

All competitive candidates for SES positions with the Federal Government must demonstrate leadership experience indicative of senior executive level management capability. To meet the minimum qualification requirements for this position, you must show in your resume that you possess the Fundamental Competencies, five Executive Core Qualifications, and the Professional/Technical Qualifications listed below. Evidence of this experience must be incorporated into your five page resume. Separate narratives for the Executive Core Qualifications and/or Professional/Technical Qualifications will not be accepted or considered. Typically, experience of this nature is gained at or above the GS-15 grade level in the Federal service, or its equivalent with state or local government, the private sector, or nongovernmental organizations.

Fundamental Competencies:
Interpersonal Skills, Oral Communication, Integrity/Honesty, Written Communication, Continual Learning, and Public Service Motivation.

Executive Core Qualifications (ECQs)

Leading Change: The ability to bring about strategic change, both within and outside the organization, to meet organizational goals. Inherent to this ECQ is the ability to establish an organizational vision and to implement it in a continuously changing environment.

Leading People: The ability to lead people toward meeting the organization's vision, mission, and goals. Inherent to this ECQ is the ability to provide an inclusive workplace that fosters the development of others, facilitates cooperation and teamwork, and supports constructive resolution of conflicts.

Results Driven: The ability to meet organizational goals and customer expectations. Inherent to this ECQ is the ability to make decisions that produce high-quality results by applying technical knowledge, analyzing problems, and calculating risks.

Business Acumen: The ability to manage human, financial, and information resources strategically.

Building Coalitions: The ability to build coalitions internally and with other Federal agencies, State and local governments, nonprofit and private sector organizations, foreign governments, or international organizations to achieve common goals.

Professional/Technical Qualifications (PTQs)

This position also requires that you possess PTQs that represent knowledge, skills, and abilities essential for success in this role. The following PTQs must be evident in your resume.

Knowledge of the policy, operations and fiscal procedures for the nation's health care programs, their interrelationships, and the social, political, and economic forces that affect them.

Ability to lead the development and issuance of complex health policy regulations and documents.

It is STRONGLY recommended that you visit the following Office of Personnel Management (OPM) webpage for more information regarding the Fundamental Competencies and ECQs.
https://www.opm.gov/policy-data-oversight/senior-executive-service/executive-core-qualifications/#url=Overview

If selected, you will be required to complete an ECQ package by drafting narratives for each of the ECQs for submission and certification by an OPM Qualifications Review Board (QRB) in order to be placed in this position. If you are currently serving in a career SES appointment, are eligible for reinstatement into the SES, or have successfully completed an SES Candidate Development Program approved by the Office of Personnel Management (OPM), you will not need to draft the ECQs.

Education

This job does not have an education qualification requirement.

Additional information

Salary for SES positions varies depending on qualifications. The annual salary range is found at the top of this announcement. The selectee for this position may be eligible for annual performance bonuses and performance-based pay adjustments.

Veteran's Preference does not apply to the SES.

How You Will Be Evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

We use a multi-step process to evaluate and refer applicants:

Minimum requirements: Your application must show that you meet all requirements, including the education and/or experience required for this position. You may be found 'not qualified' if you do not possess the minimum competencies required for the position. If your application is incomplete, we may rate you as ineligible.

Rating: A panel of Senior Executives will review your application and evaluate your qualification for this position based on the information in your application. Your application will be rated, based on the extent and quality of your experience, education, and training relevant to the duties of this position. Interviews will be at the discretion of the panel and/or selection official.

Referral: If you are among the top qualified candidates, your application will be referred to a selection official for consideration and possible interview.

Background checks and security clearance

Security clearance
Not Required

Drug test required
No

Position sensitivity and risk
Moderate Risk (MR)

Trust determination process

Required Documents

All applicants are required to submit and/or complete the following documents to be considered for the position:

Resume that contains your full name, address and phone number, and does not exceed the five page limit;

Cover Letter (optional);

Online Assessment Questionnaire. To preview the assessment questionnaire, click here: https://apply.usastaffing.gov/ViewQuestionnaire/10907134

NOTE: THE USAJOBS RESUME TEMPLATE MAY RESULT IN A RESUME BEING LONGER THAN FIVE PAGES. PLEASE VERIFY PAGE LENGTH BEFORE SUBMISSION OF APPLICATION.

Applicants who are currently, or were previously, Federal employees must also submit:

An SF-50 showing your current or former civil service status; and

Proof of OPM Qualifications Review Board certification (OPM-approved SES Candidate Development Program graduates), if applicable.

NOTE: Documents submitted that are not listed in the Required Documents section of this announcement will not be considered or forwarded to the rating panel or selecting official.