Supervisory Health Insurance Specialist- CMS

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Office of Financial Management(OFM), Payment Accuracy and Reporting Group, Division of Medicare Advantage and Drug Error Rate.

As a Supervisory Health Insurance Specialist, GS-0107-15, you will be responsible for providing leadership and executive direction over the activities of Medicare Advantage and Medicare Prescription improper payment measurement program.

Occasional travel – You may be expected to travel up to 5% for this position.

• As the MADER Director, the incumbent is directly responsible overseeing the budget and human resource activities for MADER to accomplish the Medicare Part C and Medicare Part D measurement development program missions.
• Identifies and discusses with internal and external groups, problems, vulnerabilities, or potential changes.
• Assigns work to subordinates based on priorities, selective consideration of the difficulty and requirements of assignments, and the capabilities of employees.
• Communicate Medicare Part C and Medicare Part D improper payment findings to stakeholders throughout the agency so that steps can be taken to reduce errors and improve the integrity of the Medicare Part C and Medicare Part D programs.
• Presents resource issues to senior management, including performing a gap analysis of current resources to projected needs based on the group’s workload and makes recommendation for what is needed for MADER to accomplish the program’s mission.
• You must be a U.S. Citizen or National to apply for this position.
• You will be subject to a background and suitability investigation.
• Time-in-Grade restrictions apply.
• THIS POSITION IS SUBJECT TO THE COVID-19 VACCINE MANDATE AS A CONDITION OF EMPLOYMENT.

ALL QUALIFICATION REQUIREMENTS MUST BE MET WITHIN 30 DAYS OF THE CLOSING DATE OF THIS ANNOUNCEMENT.
Your resume 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 receiving further consideration.
In order to qualify for the GS-15
, 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-14 grade level in the Federal government, obtained in either the private or public sector, to include:

• 1) Providing leadership in the operational review and administration of Medicare Fee For Service (FFS), Medicare Advantage (Medicare Part
  
  C), Medicare Prescription Drug (Medicare Part
  
  D), Medicaid, or Children’s Health lnsurance Program (CHIP) improper payment measurement programs; AND
• 2) Providing oversight to ensure that program integrity efforts to identify improper payments follow the applicable payment laws, regulations or policies; AND
• 3) Recommending improvements on improper payment measurement programs; AND
• 4) Briefing stakeholders on payment vulnerabilities.

This job does not have an education qualification requirement.

Bargaining Unit Position:
No

Tour of Duty:
Flexible

Recruitment/Relocation Incentive:
Not Authorized

Financial Disclosure:
Required

COVID-19 Vaccine Mandate:
In accordance with Executive Order 14043 , Federal employees are required to be fully vaccinated against COVID-19 regardless of the employee’s duty location or work arrangement (e.g., telework, remote work, etc.), subject to exceptions that may be required by law. If selected, you will be required to submit proof of vaccination by November 22, 2021 or before your entrance on duty…