Health Insurance Specialist

Centers for Disease Control and Prevention • Atlanta, GA

17d

About The Position

This position is with the Department of Health and Human Services, National Institute for Occupational Safety and Health, headquartered in Atlanta, Georgia. The Health Insurance Specialist oversees member relations and helps ensure accurate, consistent delivery of health plan services and benefits. The role directs program improvement initiatives, serves as a liaison to resolve member concerns, and coordinates cross-functional activities to support deadlines and organizational priorities.

Requirements

• At least one year of specialized experience equivalent to at least the GS-11 grade level in the Federal service, including all specified specialized-experience areas.
• U.S. citizenship is required.
• Males born after December 31, 1959, must be registered with or exempt from Selective Service.
• Must meet time-in-grade restrictions by the announcement closing date.
• Must successfully complete a background security investigation and receive favorable adjudication.
• All qualification requirements must be met by the announcement closing date.
• Applicants must document experience clearly, including exact employment dates and hours worked per week for part-time experience.
• A financial disclosure statement may be required.
• A probationary or trial period may be required.

Responsibilities

• Oversee member relations activities to ensure accurate and consistent delivery of health plan services and benefits to program participants.
• Direct program improvement initiatives by establishing operating procedures, coordinating cross-cutting activities, and incorporating emerging industry practices into member service operations.
• Serve as a program liaison to facilitate resolution of member concerns and support consistent administration of health plan services.
• Coordinate cross-functional program activities to maintain accountability, meet established deadlines, and advance organizational priorities.
• Administer member services or health benefit activities by interpreting program requirements, resolving member-related issues, and preparing correspondence or guidance in accordance with federal health plan policies and procedures.
• Analyze enrollment, member service, or program data to identify trends, evaluate operational processes, and develop recommendations to improve program effectiveness.
• Coordinate with health professionals, medical administrators, or program staff to address member service issues and develop recommendations concerning health plan services or benefits.
• Monitor program deliverables, prepare administrative or decision support documents, and support implementation of operational improvement initiatives.

Benefits

• Federal employees and their families have access to a comprehensive benefits package. Specific benefit eligibility depends on position type; applicants should contact the hiring agency for details.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed