Health Insurance Specialist

Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicaid and CHIP Services (CMCS), Division of Reimbursement Policy (DRP). As a Health Insurance Specialist, GS-0107-13, you will serve as an expert in the development, evaluation, and implementation of policies related to Medicaid non-institutional reimbursements and state financing policies.

Duties

• •Review State Plan Amendments and provides technical assistance to the States on Medicaid institutional and non-institutional reimbursement.
• •Provide advice and consultation in the development, recommendation, and evaluation of proposed, modified, or new legislation and regulations to assess impact on Medicaid institutional reimbursement and state financing policies.
• •Conduct analytical studies and provide recommendations for improvements to the Medicaid program, operating policies and procedures, program guidance and instructions.
• •Provide technical advice on all aspects of grant/financial mechanisms; and ensures compliance with established administrative and financial policies, procedures, and sound business practices.

Qualifications

ALL QUALIFICATION REQUIREMENTS MUST BE MET BY 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-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) Interpreting statutes, regulations, and policies related to Medicaid or Other Health Insurance Program to provide technical guidance or to apply to the other program related tasks; 2) Conducting analyses using national and/or state level health services data to evaluate health service delivery or payments; AND 3) Interpreting and implementing regulations pertaining to Medicaid financing, grant management, or other related budgetary activities to manage and provide program oversight, (i.e., contracts, intergovernmental agency agreements, discretionary grants, general acquisitions). 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/13079369