Health Insurance Specialist

Centers for Medicare & Medicaid Services • Woodlawn, MD

9d

About The Position

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Program Integrity (CPI). The Health Insurance Specialist, GS-0107-7/9, performs assignments associated with education, outreach, and customer service for private health insurance consumers, beneficiary and provider populations, interest groups, and other stakeholders.

In a developmental capacity, the incumbent prepares and implements elements of tactical communications plans or strategic partnerships that provide information and promote awareness of limited segments of CMS programs and initiatives. The position involves supporting CMS education strategies, outreach and training initiatives, stakeholder communications, and routine analysis of program initiatives.

The incumbent serves as a conduit between CMS and external stakeholders, gathers feedback, participates in studies and surveys, and supports regional offices and contracted stakeholders. The position also involves responding to routine program-related inquiries and evaluating program effectiveness through data gathering, organization, interpretation, and fact-supported recommendations.

Requirements

• U.S. citizenship or nationality.
• Must meet all qualification requirements within 30 days of the announcement closing date.
• Resume limited to no more than two pages and documenting relevant responsibilities and specialized experience.
• For GS-07: At least one year of specialized experience equivalent to GS-05, including drafting consumer education materials about health insurance program options; gathering background information for routine outreach or liaison activities under senior specialist guidance; and researching applicable laws, regulations, or policies to respond to routine health insurance program inquiries.
• For GS-07, qualifying education may substitute for experience: a bachelor's degree with superior academic achievement; one full year of qualifying graduate education; or a qualifying combination of experience and education. Transcripts are required when claiming education substitution or combination.
• For GS-09: At least one year of specialized experience equivalent to GS-07, including preparing and disseminating consumer education materials; participating in outreach activities such as public relations events, conferences, or presentations; and conducting studies to identify potential areas for health insurance education or training interventions.
• For GS-09, qualifying education may substitute for experience: a related master's or equivalent graduate degree, two full years of progressively higher-level graduate education leading to such a degree, or a related LL.B. or J.D. Transcripts are required when claiming education substitution or combination.
• Applicants claiming a combination of experience and education must meet the specified grade-level requirements and provide transcripts as applicable.
• Current or former federal employees subject to time-in-grade restrictions must have served at least 52 weeks at the next lower grade level, as applicable.
• Subject to a background and suitability investigation.
• A one-year probationary period may be required.
• Select Service registration or exemption is required for males born after December 31, 1959.
• Federal salary payments must be made by direct deposit.
• If selected, identity and employment eligibility documentation will be verified through the DHS E-Verify System.

Responsibilities

• Prepare and implement elements of tactical communications plans or strategic partnerships to provide information and promote awareness of selected CMS programs and initiatives.
• Participate in studies to identify potential problem areas that may benefit from education and training interventions.
• Serve as a conduit between internal CMS and external stakeholders and obtain feedback to help CMS implement education strategies about its health insurance programs.
• Conduct field studies and surveys related to education and training.
• Provide guidance and assistance to regional offices and contracted stakeholders on education, outreach, and training initiatives.
• Assist in providing training and assistance to regional offices for reviewing and evaluating institutional provider, physician, supplier, and beneficiary overpayment recovery and third-party systems.
• Respond to routine inquiries about program-related activities from internal and external stakeholders.
• Conduct routine analytical studies and evaluate program initiatives by gathering, organizing, and interpreting data and making recommendations supported by facts and background information.

Benefits

• A comprehensive federal employee benefits package is available to eligible employees and their families; specific eligibility depends on position type.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level