Health Insurance Specialist (Program Integrity)

This position is located in the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) Center for Program Integrity,Provider Compliance Group. As a Health Insurance Specialist (Program Integrity) GS-0107-13 you will review regulatory guidance and CMS program changes developed reporting tools to analyze data improve compliance and efficiency support leadership decisions and ensure alignment with federal requirements. Qualifications ALL QUALIFICATION REQUIREMENTS MUST BE MET WITHIN 30 DAYS OF THE CLOSING DATE OF THIS ANNOUNCEMENT. Your resume (limited to no more than 2 pages) 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 being considered further. In order to qualify for the GS-13 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-12 grade level in the Federal government obtained in either the private or public sector to include 1. Identifying health insurance program vulnerabilities to detect fraud waste or abuse 2. Collaborating across organizational lines in support of program integrity educational efforts or oversight of health insurance programs AND 3. Developing and implementing policies for program integrity stakeholder and engagement activities. 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. Time-in-Grade To be eligible current Federal employees must have served at least 52 weeks (one year) at the next lower grade level from the position/grade level(s) to which they are applying. Click the following link to view the occupational questionnaire