This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Consumer Information and Insurance Oversight, (CCIIO), Marketplace Plan Management Group (MPMG) . As a Supervisory Health Insurance Specialist, GS-0107-14, you will serve as the Division Deputy Director in directing the review and analyzing of qualified health plans (QHPs) issuers and plans.
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-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) Overseeing program operations related to Qualified Health Plans (QHPs) review in Federally Facilitated Exchanges (FFEs); 2) Developing policy, operational, or business requirements to ensure compliance with ACA provisions for QHP (Qualified Health Plan) certification; AND 3) Planning, organizing, or assessing the work activities of subordinate employees. 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 or former Federal employees and current or former Federal employees applying under the VEOA eligibility who hold or have held a permanent General Schedule position in the previous year 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/12791725
Direct the review and analysis of qualified health plans (QHPs) issuers and plans, particularly QHPs in the Federally-facilitated Marketplaces (FFMs), to ensure compliance with PPACA provisions related to QHP certification.
Direct the development and updates to standard operating procedures and other sub-regulatory guidance’s that instruct issuers on the conduct of benefit review for plans offered in markets under the FFMs.
Conduct benefit and cost sharing reviews, and facilitates collaboration with CMS actuaries responsible for rate reviews, and oversees the provision of technical assistance to issuers, and notices of approval and disapproval to issuers.
Represent the Division Director, or CMS, in contacts w/ State Departments of Insurance, the National Association of Insurance Commissioners and other internal/external stakeholders regarding controversial and sensitive matters.