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Summary 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, Division of Financial Risk. As a Health Insurance Specialist, GS-0107-13, you will develop compliance, audit, and oversight requirements, policies, and operating procedures related to activities and processes involved with the monitoring and oversight of external CMS stakeholders. Responsibilities Serve as an expert in the development, evaluation, and implementation of policies related to activities and processes involved with the monitoring and oversight of external CMS stakeholders. Lead tasks designed to develop, evaluate, and implement Medicare, Medicaid, CHIP, Marketplace Exchange, and private health insurance programs. Develop, implement, and maintain operational requirements, a comprehensive program oversight strategy including standard operating procedures for oversight of entities that provide health care and prescription drug services. Develop and review health care policies and legislation in order to draft related policy documents, regulations, procedures and guidance to states. Coordinate and prepare responses to oversight entities including the Office of the Inspector General (OIG) and Government Accountability Office (GAO) and monitor progress of associated corrective action plans. Requirements Conditions of Employment Qualifications ALL QUALIFICATION REQUIREMENTS MUST BE MET WITHIN 30 DAYS OF THE CLOSING DATE OF THIS ANNOUNCEMENT. Your resume (limited to no more than 2 pages) 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 being considered further. 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) Coordinating complex value-based care; (2) Developing strategies to engage stakeholders for value-based care; (3) Analyzing policy to improve operations to value-based care; AND (4) Analyzing policy to draft comprehensive stakeholder communications. 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/12855615 Education Additional Information Bargaining Unit Position: Yes- American Federation of Government Employees, Local 1923 Tour of Duty: Flexible Recruitment Incentive: Not Authorized Relocation Incentive: Not Authorized Financial Disclosure: Not Required Workplace Flexibility at CMS: This position has a regular and recurring reporting requirement to the CMS office listed in this announcement. CMS offers flexible working arrangements and allows employees the opportunity to participate in alternative work schedules at the manager's discretion. The Career Transition Assistance Plan (CTAP) provide eligible displaced federal employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit the required documentation and be rated well-qualified for this vacancy. Click here for a detailed description of the required supporting documents. A well-qualified applicant is one whose knowledge, skills and abilities clearly exceed the minimum qualification requirements of the position. Additional information about CTAP eligibility is on OPM's Career Transition Resources website at www.opm.gov/rif/employee_guides/career_transition.asp.