Centers for Medicare & Medicaid Services Health Insurance Specialist in Boston, Massachusetts

  • Duties

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Duties
Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Consortium for Medicare Health Plan Operations, Boston Customer Relations Branch.

As a Health Insurance Specialist, GS-0107-11, you will perform program policy work related to national health insurance programs, such as Medicare, Medicaid, the Children's Health Insurance Program (CHIP), Marketplace Exchange/private health insurance.

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Responsibilities
  • Analyze and interpret Federal regulations, policy statements, and other program guidance.
  • Propose modifications to policies to reflect changes or trends in the health care industry, program objectives and the needs of beneficiaries.
  • Prepare and coordinate a variety of written products, including position papers and briefing materials for senior officials to use as background information on program policy related activities
  • Respond to inquiries regarding program policies to a variety of internal and external stakeholders(e.g., beneficiaries, providers, and representatives of public and private organizations, congressional staff, and other government organizations).
  • Work with States, other key stakeholders, and CMS staff to identify and address evolving program issues or to provide guidance on programmatic matters.
Travel Required

Not required

Supervisory status

No

Promotion Potential

12

  • #### Job family (Series)

0107 Health Insurance Administration

  • Requirements

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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.
Qualifications

ALL QUALIFICATION REQUIREMENTS MUST BE MET BY THE CLOSING DATE OF THIS ANNOUNCEMENT.

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 in the development or revision of processes used for the oversight of a health insurance program; (2) Monitoring entities for compliance with health insurance program regulations and policies; and (3) Preparing briefing materials, manuals, or reports for health insurance program improvements.

- OR - Substitution of Education for Experience: You may substitute education for specialized experience at the GS-11 level by possessing 3 full years of progressively higher level graduate education leading to such a degree or Ph.D. 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 master's 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.

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/10418076

Education
Additional information

Bargaining Unit Position: Yes Tour of Duty:Flexible Recruitment/Relocation Incentive:Not Authorized Financial Disclosure: Not Required

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.

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/employeeguides/careertransition.asp.

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.

Additional selections may be made from this announcement for similar positions within CMS in the same geographical location. For Central Office vacancies, the "same geographical location" includes Baltimore, Maryland; Bethesda, Maryland; and Washington, D.C.

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.

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How You Will Be Evaluated

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

If you meet the minimum qualifications and education requirements for this position, your application and responses to the online occupational questionnaire will be evaluated under Category Rating and Selection procedures for placement in one of the following categories:

  • 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 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).

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):

  • Oral Communication
  • Oversight
  • Policy Analysis
  • Written Communication

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.

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Background checks and security clearance
Security clearance

Not Required

Drug test required

No

  • Required Documents

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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.

  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.

PLEASE NOTE: A complete application package includes the online application, resume, transcripts (if qualifying through education substitution or a combination of education and experience) 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 (if applicable) and CMS required documents, will result in you not being considered for employment.

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.

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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. Learn more about federal benefits.

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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 to Apply

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How to Apply

Your complete application package, as described in the "Required Documents" section, must be received by 11:59 PM ET on 02/26/2019 to receive consideration.

IN DESCRIBING YOUR WORK EXPERIENCE AND/OR EDUCATION, PLEASE BE CLEAR AND SPECIFIC REGARDING YOUR EXPERIENCE OR EDUCATION.

We strongly encourage applicants to utilize the USAJOBS resume builder in the creation of resumes. Please ensure EACH work history includes ALL of the following information:

  • Official Position Title (include series and grade if Federal job)
  • Duties (be specific in describing your duties)
  • Employer's name and address
  • Supervisor name and phone number
  • Start and end dates including month, day and year (e.g. June 18, 2007 to April 05, 2008)
  • Full-time or part-time status (include hours worked per week)
  • Salary Determining length of general or specialized experience is dependent on the above information and failure to provide ALL of this information WILL result in a finding of ineligible.
  • To begin, click Apply to access the online application. 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 prompts to select your resume and/or other supporting documents to be included with your application package. You will have the opportunity to upload additional documents to include in your application before it is submitted. Your uploaded documents may take several hours to clear the virus scan process.
  • After acknowledging you have reviewed your application package, complete the Include Personal Information section as you deem appropriate and click to continue with the application process.
  • You will be taken to the online application which you must complete in order to apply for the position. Complete the online application, verify the required documentation is included with your application package, and submit the application. To verify the status of your application, log into your USAJOBS account (https://my.usajobs.gov/Account/Login), all of your applications will appear on the Welcome screen. 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/.

This agency provides reasonable accommodation to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please send an email to Donna.cottman@cms.hhs.gov. The decision to grant reasonable accommodation will be made on a case-by-case basis.

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. 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.

Applicants eligible under Schedule A authority who are interested in applying for this position must submit their resume, Schedule A documentation, transcripts (if positive education required or qualifying through education substitution), and cover letter (optional) to Donna.cottman@cms.hhs.gov. You MUST include the Job Announcement Number in the subject line of the email to receive consideration for the position. For additional information regarding Schedule A authority click here.

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Agency contact information
Donna Cottman
Phone

000-000-0000

Email

Donna.cottman@cms.hhs.gov

Address

Consortium for Medicare Health Plan Operations 7500 Security Blvd Woodlawn, MD 21244 US

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Next steps

Once your online application is submitted, you will receive a confirmation notification by email. Your application will be evaluated to determine your eligibility and qualifications for the position. After the evaluation is complete, you will receive another email notification regarding the status of your application.

Within 30 business days of the closing date,02/26/2019, you may check your status online by logging into your USAJOBS account (https://my.usajobs.gov/Account/Login). We will update your status after each key stage in the application process has been completed.

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  • Fair & Transparent
Fair & Transparent

The Federal hiring process is setup to be fair and transparent. Please read the following guidance.

Equal Employment Opportunity Policy

The United States Government does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor.

  • Equal Employment Opportunity (EEO) for federal employees & job applicants

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Reasonable Accommodation Policy

Federal agencies must provide reasonable accommodation to applicants with disabilities where appropriate. Applicants requiring reasonable accommodation for any part of the application process should follow the instructions in the job opportunity announcement. For any part of the remaining hiring process, applicants should contact the hiring agency directly. Determinations on requests for reasonable accommodation will be made on a case-by-case basis.

A reasonable accommodation is any change to a job, the work environment, or the way things are usually done that enables an individual with a disability to apply for a job, perform job duties or receive equal access to job benefits.

Under the Rehabilitation Act of 1973, federal agencies must provide reasonable accommodations when:

  • An applicant with a disability needs an accommodation to have an equal opportunity to apply for a job.
  • An employee with a disability needs an accommodation to perform the essential job duties or to gain access to the workplace.
  • An employee with a disability needs an accommodation to receive equal access to benefits, such as details, training, and office-sponsored events.

You can request a reasonable accommodation at any time during the application or hiring process or while on the job. Requests are considered on a case-by-case basis.

Learn more about disability employment and reasonable accommodations or how to contact an agency.

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Legal and regulatory guidance
  • Financial suitability
  • Social security number request
  • Privacy Act
  • Signature and false statements
  • Selective Service
  • New employee probationary period

This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/GetJob/ViewDetails/523664900. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.

Open & closing dates: 02/11/2019 to 02/26/2019

Service: Competitive

Pay scale & grade: GS 11

Salary: $67,643 to $87,940 per year

Appointment type: Permanent

Work schedule: Full-Time