Health Insurance Specialist

Centers for Medicare & Medicaid Services•San Francisco, CA

About The Position

The Centers for Medicare & Medicaid Services (CMS), within the Department of Health & Human Services, is hiring Health Insurance Specialists at the GS-7 and GS-9 levels through the Pathways Recent Graduate program. The role involves health insurance policy development, research, analysis, and program development. Specialists research health insurance program issues, analyze findings, recommend solutions to management, review and develop program documents with senior analysts and management, evaluate program efficiency and effectiveness, review draft regulations and responses to proposed regulations, and assist with health insurance program audits. Applicants must meet the Recent Graduate or Fall 2026 Degree Candidate eligibility requirements, including a cumulative GPA of at least 3.0 on a 4.0 scale. Candidates must also meet the applicable GS-7 or GS-9 qualification requirements through specialized experience, education, superior academic achievement where applicable, or a combination of experience and education. The position requires U.S. citizenship or national status, a background and suitability investigation, and signing a Pathways Participant Agreement before starting. The announcement states that employees have a regular and recurring reporting requirement to a CMS office listed in the announcement. Flexible working arrangements and alternative work schedules may be available at the manager’s discretion. The position is a bargaining-unit position represented by AFGE Local 1923. The tour of duty is flexible. Recruitment or relocation incentives are not authorized, and financial disclosure is not required. Recent Graduates may be eligible for noncompetitive conversion after successful completion of the program. Employees may be eligible for promotion up to GS-11 during the Pathways Program and up to GS-12 after successful completion, with no guarantee of future promotions. Salary ranges vary by grade and duty location: GS-7 salaries range from $51,283 to $82,007, and GS-9 salaries range from $62,729 to $100,315.

Requirements

Be a U.S. Citizen or National.
Have a cumulative GPA of at least 3.0 on a 4.0 scale, subject to the stated rounding rules.
Meet the Recent Graduate or Fall 2026 Degree Candidate eligibility requirements and submit required transcripts and education documentation.
For GS-7, qualify through one year of specialized experience equivalent to GS-5, one full year of graduate-level education, a bachelor's degree with superior academic achievement, or an eligible combination of education and experience.
For GS-9, qualify through one year of specialized experience equivalent to GS-7, a master's or equivalent graduate degree, at least two years of progressively higher-level graduate education leading to such a degree, an LL.B. or J.D., or an eligible combination of experience and excess graduate education.
For GS-7 specialized experience, demonstrate assisting with routine analytical studies and preparing written materials for senior staff.
For GS-9 specialized experience, demonstrate performing routine analytical studies related to healthcare programs or policies and assisting with development of health insurance operational guidance, policies, reports, or procedures.
Undergo a background and suitability investigation.
Sign a Pathways Participant Agreement before starting employment.
Submit all required transcripts at the time of application when relying on education for qualification; degree candidates must provide evidence of degree conferral by January 31, 2027.
Males born after December 31, 1959, must be registered or exempt from Selective Service.
Federal salary payments must be made by direct deposit.
If selected, documentation presented for Form I-9 will be verified through DHS E-Verify.

Responsibilities

Research health insurance program issues, analyze findings, and recommend solutions to management.
Review, analyze, and develop program documents in collaboration with senior analysts and management.
Review, evaluate, and analyze health insurance programs for efficiency and effectiveness.
Review draft regulations and responses to CMS proposed regulations.
Assist with administration of health insurance program audits.