[nfbwatlk] Health Insurance Specialist, GS-0107-11/12, Job Announcement Number: HHS-CMMS-MP/DE-13-763914, Open October 15 to October 26, 2013

Mon Oct 21 15:53:22 UTC 2013

Link:
https://www.usajobs.gov/GetJob/ViewDetails/328525400

Text:
Job Title: Health Insurance Specialist, GS-0107-11/12
Department: Department Of Health And Human Services
Agency: Centers for Medicare & Medicaid Services
Job Announcement Number: HHS-CMMS-MP/DE-13-763914
SALARY RANGE: $61,255.00 to $95,444.00 / Per Year
OPEN PERIOD: Tuesday, October 15, 2013 to Saturday, October 26, 2013
SERIES & GRADE: GS-0107-11/12
POSITION INFORMATION: Full Time - Permanent
PROMOTION POTENTIAL: 12
DUTY LOCATIONS:  1 vacancy in the following location:
Seattle, WA United States
WHO MAY APPLY: US Citizens and Status Candidates

JOB SUMMARY:
Become a part of the Department that touches the lives of every American! At the Department of Health and Human Services (HHS) you can give back to your community, state, and country by making a difference in the lives of Americans everywhere. It is the principal agency for protecting the health of citizens. Join HHS and help to make our world healthier, safer, and better for all Americans.

The Centers for Medicare and Medicaid Services (CMS) works in partnership with the entire health care community to improve quality and efficiency in an evolving health care system and provides leadership in the broader health care marketplace. Our effectiveness depends on the capabilities of a dedicated, professional staff that is committed to supporting these objectives. A career with CMS offers the opportunity to get involved on important national health care issues and be part of a dynamic, fast-paced, and highly visible organization.  For more information on CMS, please see: http://www.cms.gov/

Applications are also accepted from current members of the PHS Commissioned Corps. PHS Commissioned Corps Officers interested in performing the duties of this position within the Commissioned Corps (not as a career/career-conditional employee) are encouraged to apply.

Additional selections may be made from this announcement for similar positions within CMS in the same geographical location.

KEY REQUIREMENTS
*You must be a U.S. citizen or national to apply for this position.
*Suitability for Federal employment determined by background investigation.
*May be required to serve a one-year probationary period.
*You must meet the Selective Service requirements, if applicable.
*All supporting documents must be received by the closing date.

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DUTIES:
As a Health Insurance Specialist in the Consortium for Quality Improvement and Survey & Certification Operations, Division of Survey and Certification, in a Regional office,  you will serve as a region wide analyst responsible for one or more specific provider areas.

Specifically, you will:
* Be responsible for administering CMS' mission of programs with a focus on quality improvement in collaboration with providers, suppliers, and stakeholders
* Provide technical, clinical, and professional expertise in interpreting and applying policies, regulations, and standards, reviewing and certifying new applicants, and processing recertification.
* Collaborate with other components of CMS and the Department in the enforcement of standards, certification of providers, agency clearances, and fraud and abuse investigations.
* Work on the development and revision of Standard Operating Procedures related to certification activities, evaluating their effectiveness, and ensure their implementation.

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QUALIFICATIONS REQUIRED:
In order to be qualified at the GS-11 level, you must possess one of the following:
A.   One year of specialized experience, equivalent to at least the GS-09 level in the Federal service, utilizing knowledge of Titles XVIII and XIX of the Social Security Act, and guidelines related to the approval of providers and suppliers for participation in the Medicare and/or Medicaid programs; monitor and evaluate the day-to-day administration of the Medicare/Medicaid certification and enforcement activities for multiple providers/suppliers; provide oversight to State Agencies, providers and other stakeholders to ensure program compliance. - OR -
B.   A PhD in healthcare administration, business administration, public administration, or a closely related field which provided the knowledge, skills, and abilities to do the work of the position. - OR -
C.   A combination of the specialized experience as described in A and graduate education as described in B that, when combined, equals 100% of the total requirement.   (Please note that only graduate education in excess of the first two years may be used in this calculation.)

In order to be qualified at the GS-12 level, you must possess one year of specialized experience, equivalent to at least the GS-11 level in the Federal service, providing technical, clinical and/or professional expertise in interpreting and applying Medicare/Medicaid laws, regulations, and procedures related to State survey and certification; reviewing and certifying providers and suppliers for participation in the Medicare/Medicaid program, and process recertification; plans, coordinate and implement survey and accreditation/deeming programs for providers and suppliers by Accrediting Organizations.

Foreign Education:  If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show that the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program.  For further information, click on foreign education

Time-in-Grade : Career or career-conditional current and former Federal employees who select to apply under merit promotion procedures must have served 52 weeks at the next lower grade level of this position.

Conditions of Employment:

1. Security and Background Requirements: If not previously completed, a background security investigation will be required for all appointees.  Appointment will be subject to the applicant's successful completion of a background security investigation and favorable adjudication.  Failure to successfully meet these requirements may be grounds for appropriate personnel action.  In addition, if hired, a background security reinvestigation or supplemental investigation may be required at a later time.  Applicants are also advised that all information concerning qualifications is subject to investigation.  False representation may be grounds for non-consideration, non-selection and/or appropriate disciplinary action.

·    Optional Form 306 - Declaration of Federal Employment - available at http://www.opm.gov/forms/pdf_fill/of306.pdf. This form is not required to be submitted at the time of submitting your application. However, if selected, this form will be required prior to final job offer.

2. E-Verify: If you are selected for this position, the documentation that you present for purposes of completing the Department of Homeland Security (DHS) Form I-9 will be verified through the DHS "E-Verify" System.  Federal law requires DHS to use the E-Verify System to verify employment eligibility of all new hires, and as a condition of continued employment obligates the new hire to take affirmative steps to resolve any discrepancies identified by the system.  The U.S. Department of Health and Human Services is an E-Verify Participant.

3. Direct Deposit: All Federal employees are required to have Federal salary payments made by direct deposit to a financial institution of their choosing.

4. All qualification requirements must be met within 30 days after the closing date of the announcement.

5. Financial disclosure statement may be required.

6. One-year probationary period may be required.

7. Travel, transportation, and relocation expenses will be paid: No

8. Bargaining Unit Position: Yes

9. Drug Screening Required:  No

10. Recruitment incentives may be authorized: No

11. Student loan repayment incentive authorized: No

12. Annual leave for non-federal service authorized:  No

HOW YOU WILL BE EVALUATED:
Once the application process is complete, a review of the best-qualified applications will be conducted.  The résumé and supporting documentation will be compared against the applicant's responses to the assessment questionnaire to determine if the applicant is qualified for this job. If, after reviewing the applicant's résumé and supporting documentation, a determination is made that the applicant has inflated his/her qualifications and/or experience, the applicant may lose consideration for this position and/or the applicant's score may be adjusted to more accurately reflect his/her skills and abilities.  Please follow all instructions carefully. Errors or omissions may affect your eligibility.

For Competitive Applicants/All U.S. Citizens:  Eligible candidates will be assigned to a quality category: Best Qualified, Well Qualified or Qualified.  Candidates in the highest category will be referred to the hiring agency.  Please note that applicants with veterans preference in the highest category have selection rights over applicants without veterans preference.  Applicants with veterans preference may be referred on a veterans-only certificate to the selecting official ahead of non-veterans for consideration and selection.

For Competitive Merit Promotion and Veterans Employment Opportunities Act (VEOA) Applicants:  The highest rated candidates will be referred to the hiring agency.

For Noncompetitive Applicants:  All qualified candidates will be referred to the hiring agency.

Application of Veterans' Preference:  The Category Rating process does not add veterans' preference points but protects the rights of veterans by placing them ahead of non-preference eligibles within each category.  Preference eligibles who meet the minimum qualification requirements and who have a compensable service connected disability of at least 10 percent must be listed in the highest quality category (except in the case of scientific or professional positions at the GS-09 level or higher.)

Your qualifications will be evaluated against the following competencies (knowledge, skills, abilities, and other characteristics):

·           Technical Knowledge - Medicare Rules and Regulations

·           Analytical Reasoning

·           Written Communication

To preview the assessment questionnaire, click the following link: View Occupational Questionnaire

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BENEFITS:
The Federal government offers a comprehensive benefits package.  Explore the major benefits offered to most Federal employees at http://www.opm.gov/retire/retire_jobseekers.asp.

OTHER INFORMATION:
Veterans' Preference: If you are a veteran claiming 5-point veterans' preference, you must submit a copy of your DD-214 (Member Copy 4) or an official statement (including Character of Service) from your command if currently on active duty. If you are claiming 10-point veterans' preference, in addition to the DD-214, you must also submit a Standard Form 15 (Application for 10-Point Veteran Preference) and the required supporting documents listed on that form.  For more information on veterans' preference see http://www.fedshirevets.gov/ .

Veterans Employment Opportunities Act (VEOA): To be eligible for a VEOA appointment, the veteran must 1) be a preference eligible; or 2) be a veteran separated after 3 or more years of continuous active service performed under honorable conditions. (you must submit a DD214-member copy 4).

Career Transition Assistance Programs: This program applies to Federal workers whose positions have been deemed 'surplus' or no longer needed, or an employee has been involuntarily separated from a Federal service position within the competitive service.  To receive selection priority for this position, you must be rated 'well-qualified'.  For information on how to apply and what documents to submit as an CTAP/ICTAP eligible, go to: http://www.opm.gov/rif/employee_guides/career_transition.asp#ictap.  Candidates must meet or exceed the Well-Qualified category (85) to be considered as an ICTAP eligible.

Noncompetitive Appointment Authorities: The following links contain information on the eligibility requirements to be considered under a noncompetitive appointing authority:

http://www.opm.gov/hr_practitioners/lawsregulations/appointingauthorities/
Hiring Authorities for Veterans
People with Disabilities
Selective Service: The Defense Authorization Act of 1986 requires that all male applicants born after 12/31/59 who are required to register under the Military Selective Service Act, be registered or they are not eligible for appointment to this position.  For further information concerning Selective Service requirements, please visit http://www.sss.gov/.

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HOW TO APPLY:
Your resume MUST contain all information required for Federal employment. Your resume MUST include full employment information such as periods of employment, month and year position(s) started and ended, title of position(s), employer's name and address, hours worked, description of duties, etc.

The complete Application Package must be submitted by 11:59 PM (EST) on Saturday, October 26, 2013.

To begin the process, click the Apply Online button to create an account or log in to your existing USAJOBS account. Follow the prompts to complete the assessment questionnaire. Please ensure you click the Submit My Answers button at the end of the process.

Note: To return to a previously Saved or Incomplete application you may use the following link: https://applicationmanager.gov/.

To fax supporting documents you are unable to upload, complete this cover page http://staffing.opm.gov/pdf/usascover.pdf using the following Vacancy ID: 763914.   Fax your documents to 1-478-757-3144.

Note: Retain a fax confirmation sheet of any documents submitted for your records.

If you cannot apply online:
1. Click the following link to view and print the assessment questionnaire TAG: View Occupational Questionnaire, and
2. Print this 1203FX form to provide your response to the assessment questionnaire http://www.opm.gov/forms/pdfimage/opm1203fx.pdf and
3. Fax the completed 1203FX form along with any supporting documents to 1-478-757-3144. Your 1203FX will serve as a cover page for your fax transmission.

REQUIRED DOCUMENTS:
·     Your Resume - If you use your own resume, curriculum vitae, or any other written form you choose then you must describe your job-related qualifications that include beginning and ending dates for paid and non-paid work experience, hours worked per week, month and year of employment for each job title listed.

·     Responses to the Assessment Questionnaire

      Other Supporting Documents: (Only submit if applicable to you.)

·     College transcripts (if qualifying all or in part based on your education)

·     Standard Form 50 (if you are a current or former Federal service employee)

·     Veterans' Preference documentation (Copy of DD-214 provided must show type of discharge/character of service

·     CTAP/ICTAP documentation

·     PHS Commissioned Corps Officer must submit a copy of latest personnel order

·     Noncompetitive appointing authority documentation

APPLICATION MATERIALS MUST BE RECEIVED BY 11:59PM (EASTERN TIME) BY Saturday, October 26, 2013

For Resume and Application Tips visit: http://www.usajobs.gov/Content/pdfs/Tutorials-Resume.pdf

AGENCY CONTACT INFO:
Philadelphia Services Branch
Phone: (215)861-3074
Email: PHILADELPHIA at OPM.GOV<mailto:PHILADELPHIA at OPM.GOV>

Agency Information:
HHS OPM
US Office of Personnel Management
600 Arch Street
Philadelphia, PA
19106
USA

WHAT TO EXPECT NEXT:
Once the online questionnaire is received you will receive an acknowledgement email that your submission was successful.  The most highly qualified candidates will be referred to the hiring manager for further consideration and possible interview.  We expect to make a selection within 45 days of the closing date of this announcement.  You will receive notice via email or by mail (if no email address was provided by you during the application process) once this process is completed (generally 4 - 6 weeks).

Questions about this job:
Philadelphia Services Branch
Phone: (215)861-3074
Email: PHILADELPHIA at OPM.GOV<mailto:PHILADELPHIA at OPM.GOV>

Job Announcement Number:
HHS-CMMS-MP/DE-13-763914

Control Number:328525400
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