Health Insurance Specialist

This Health Insurance Specialist position is with Centers for Medicare & Medicaid Services (Department of Health and Human Services) in Phoenix, AZ. This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare(CM), Division of Acute Care (DAC). As a Health Insurance Specialist, GS-0107-14, you will be a technical expert and principal advisor to the Director and Deputy Director, DAC, providing high-level technical and conceptual expertise on policy development and analysis, data management, quantitative analyses and policy implementation. Key duties: • Serves as IPPS payment expert, analyzing policy and data to shape Medicare hospital payment rates, incentives, and legislation impacts, advising senior leadership on IPPS policy, strategic initiatives, and payment system refinements. • Oversees QA for data, modeling, and policy analysis on inpatient valuation; leads IPPS rulemaking coordination and teams; directs analysts; advises leadership; acts for Division Director/Deputy as needed. • Advises DAC payment teams on policy and technical issues, leading work structure and development. Presents policy options to senior leaders and may represent CMS in discussions with officials, Congress, and stakeholders. • Conducts impact analyses of proposed policies and payment rates, evaluating emerging and existing policies. Applies research and new concepts to long-range inpatient payment projects, supporting senior policy makers' decisions. • Coordinates implementation of inpatient payment policies, leading related projects. Serves as resource to CM, CMS, HHS, and congressional staff; advises leadership on legislative impacts; provides technical assistance and training. 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-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. Developing or revising Medicare payment policies, regulations, or sub-regulatory guidance to implement statutory or programmatic requirements; 2. Leading projects involving Medicare payment policy development or implementation to resolve payment issues; 3. Conducting policy and data analyses to inform Medicare payment policy decisions; AND 4. Preparing briefing materials, policy papers, or presentations to communicate Medicare payment policy information to senior leadership.. 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: https://apply.usastaffing.gov/ViewQuestionnaire/13086722 View the full announcement and apply on USAJOBS.gov.