Health Insurance Specialist

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) Serve as a subject matter expert on risk adjustment operations, such as risk score and payment transfer calculations or risk adjustment data validation.; 2) Reviews new policy and legislative initiatives for potential impact on the program.; AND 3) Draft issue briefing, decision memos synthesizing critical updates, insights, and recommendations on risk adjustment or RADV policy developments and calculations for leadership consideration. 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/12574956
This position is located in the Centers for Medicare & Medicaid Services (CMS), Center for Consumer Information and Insurance Oversight (CCIIO), Division of Risk Adjustment Operations (DRAO). As a Health Insurance Specialist, GS-0107-14, you will be a authoritative subject matter expert in risk adjustment models, risk adjustment transfers, risk adjustment and RADV data analysis, methodology calculations and operations, working to further develop program policies, operations, results, and goals.