USA
22 hours ago
Health Insurance Specialist
Summary This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare (CM), Division of Part D Policy (DPDP). As a Health Insurance Specialist, GS-0107-14, you will develop, evaluate, and implement Medicare prescription drug benefit policies. Responsibilities Serves as a health insurance resource providing expert guidance on the development of coordination of benefits (COB) policies and operations with Part D organizations and other secondary payers. Conducts program-related studies and data analysis regarding the Medicare drug prescription benefit: program oversight and program policy that provides decision-makers with quantitative and qualitative data and analysis for program management. Reviews technical pharmacy transaction standard changes to ensure they meet the needs of the Part D program and works with members to ensure agency priorities are addressed within the standards. Advises high-level management officials regarding the operations, health policies, legislation or regulation, and special projects of the Medicare drug prescription benefit program. Develops technical responses to correspondence concerning the impact of program policies and data collection on Federal financing programs to the health care industry, program beneficiaries, pharmacy transaction, etc.,. Requirements Conditions of Employment Qualifications ALL QUALIFICATION REQUIREMENTS MUST BE MET BY 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-14, 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-13 grade level in the Federal government, obtained in either the private or public sector, to include: 1) Interpreting Medicare and Prescription Part D Secondary Payer statute and regulations to create coordination of benefits policies and procedures; AND 2) Reviewing technical pharmacy transactions standard changes to ensure Medicare Part D program compliance; AND 3) Identifying potential improvements or changes for the Medicare Part D program and making recommendations to implement such solutions; AND 4) Communicating technical and detailed information in a variety of formats such as regulations, briefing papers, presentations, meetings, etc. 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/12554083 Education Additional Information Bargaining Unit Position: Yes- American Federation of Government Employees, Local 1923 Tour of Duty: Flexible Recruitment/Relocation Incentive: Not Authorized Financial Disclosure: Not Authorized For more information on locality and pay scales, please click here. Workplace Flexibility at CMS: This position has a regular and recurring reporting requirement to the CMS office listed in this announcement; however, CMS offers flexible working arrangements and allows employees the opportunity to participate in telework combined with alternative work schedules at the manager's discretion. This position may be authorized for telework. Telework eligibility will be discussed during the interview process. Supervisory positions must report a minimum 2 times per week and non-Supervisory positions must report a minimum of 2 times per pay period. 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.
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