Health Insurance Specialist (Program Contractor Management)

Employer
USAJobs
Location
Woodlawn, Maryland
Posted
Feb 19, 2021
Closes
Feb 27, 2021
Hours
Full Time
Duties

Summary

Announcement extended through Thursday, 02/25/2021

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Program Integrity (CPI), Division of Program Integrity Support Contracts.

As a Health Insurance Specialist (Program Contractor Management), GS-0107-11/12, you will use program knowledge to effectively plan, identify, and design contract requirements during the planning and awarding phase of acquisition(s).
Learn more about this agency

Responsibilities

  • Provide analytical support on policy issues and topics, research background information, the origin of laws, and the intended impact in order.
  • Use program knowledge to effectively plan, identify, and design contract requirements during the planning and awarding phase of acquisition(s).
  • Document performance with special emphasis on significant trends and items of interest in the management of contractor actions.
  • Manage, monitor, and oversee contractor transition activities.
  • Develop, implement, and maintain operational requirements, including standard operating procedures, as well as databases, to manage and analyze programmatic information such as routine and ad hoc report, deliverables, and programmatic documentation.


Travel Required

Occasional travel - 5% or less

Supervisory status
No

Promotion Potential
12

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.
  • Time-in-Grade restrictions apply.


Qualifications

ALL 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-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) Monitoring contractors that support in national health care delivery, quality, or payment programs and/or maintain health care program-related databases; (2) Conducting analytical studies by interpreting health care program issues related to contract administration functions; and (3) Coordinating responses to government inquiries regarding health care program issues requiring corrective action plans.

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: A. (1) Assisting in monitoring contractors that participate in national healthcare delivery programs and/or maintain program-related databases; (2) Participating as a team member in analytical studies by gathering, organizing, and interpreting policy, program, and/or operational issues related to contract administration functions; and (3) Developing responses to inquiries regarding healthcare program integrity issues.
- OR - B. Substitution of Education for Experience: possess a Ph.D. or equivalent doctoral degree or have completed three full years of progressively higher level graduate education leading to such a degree or I possess a LL.M in a related field of study, from an accredited college and/or university. One year of full-time graduate education is considered to be the number of credit hours that the school attended has determined to represent one year of full-time study. If that information cannot be obtained from the school, 18 semester hours will satisfying the one year of full-time study requirement. (TRANSCRIPT REQUIRED AT TIME OF APPLICATION)
- OR - C. Combination of Experience and Education: combination of specialized experience as described in "A" above and graduate education as described in "B" above. To combine education and experience, determine the total qualifying experience as a percentage of the experience required for the grade level. Then determine the education as a percentage of the education required for the grade level. Finally, add two percentages. The total percentage must equal at least 100 percent.

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.

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/11032441

Education

This job does not have an education qualification requirement.

Additional information

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 .
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 OPM's Career Transition Resources website at www.opm.gov/rif/employee_guides/career_transition.asp .

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):
  • Contracting/Procurement
  • Health Insurance
  • Oral Communication
  • Written Communication


Background checks and security clearance

Security clearance
Not Required

Drug test required
No

Position sensitivity and risk
Non-sensitive (NS)/Low Risk

Trust determination process
Credentialing , Suitability/Fitness

Required Documents

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/dd/yy) 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.

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