This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid Innovation, Seamless Care Models Group (SCMG). As a Health Insurance Specialist, GS-0107-13, you will identify and develop innovations in care that enable health care professionals in different settings to work together to care for patients.
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-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 and extracting quality care measures for implementation in value-based payment systems; 2) Developing financial methodologies to improve quality performance in value-based care; AND 3) Analyzing policy to improve operations for alternative payment models intended to promote value-based care. 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/12828752
Evaluate and analyze the impact on alternative payment models being tested or developed by CMS of new or revised changes to legislation before the Congress pertaining to any CMS program.
Identifies and proposes modifications to policies to reflect changes or trends in the health care industry, program objectives and the needs of beneficiaries.
Analyzes data from a variety of sources, including Medicare, Medicaid, and/or other health insurance claims and administrative data.
Analyzes data to interpret how alternative approaches to payment impact health and cost outcomes and quality of care.
Respond to routine inquiries and communicate regarding model policies to a variety of internal and external stakeholders.