HEALTH INSURANCE SPECIALIST
Health & Human Services, Centers for Medicare & Medicaid Services - Chicago, IL

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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.

This position is located in the Consortium for Financial Management & Fee-For-Service Operations, Chicago Division of Financial Management and Fee-For-Service Operations, Chicago Medicare Operations as a Health Insurance Specialist.

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 who are committed to supporting these objectives. A career with CMS offers the opportunity to get involved in important national health care issues and be part of a dynamic, fast-paced, and highly visible organization.

This is a competitive vacancy, open to all United States citizens, advertised under Delegated Examining Authority. Selections made under this vacancy announcement will be processed as a new appointment to the civil service. Current civil service employees would therefore be given new appointments to the civil service. Applications are also accepted from current members of the Commissioned Corps and Certain Military Spouse.

More than 1 selection may be made from this announcement.

KEY REQUIREMENTS:
U.S. Citizenship is required.

You must meet the minimum qualifications as stated in the announcement.

Background and/or Security Investigation is required.

Be sure to read the "How to Apply" section for all required documents.

You may be required to complete a one year probationary period.

Duties

Additional Duty Location Info:
1 vacancy - Chicago Metro area, IL

Major Duties: In this position you will serve as a Health Insurance Specialist for the Chicago Medicare Operations Branch.

Specifically, you will:
  • Provide technical assistance in a number of program areas within the Medicare Financial Management and Fee-For-Service (FFS) arena;
  • Work with Medicare contractors, providers, and beneficiaries regarding applicable laws, regulations, and policies associated with the Medicare FFS Program;
  • Be responsible for developing specific projects or studies by reviewing policy and other factual data to identify issues or problems;
  • Participate in the review and analysis of proposed regulations and guidelines impacting Medicare program operations and provide assistance in researching and gathering information pertaining to Medicare policy issues; and
  • Identify trends and problems to revisions or changes to existing program policies, criteria, standards, and procedures.
Qualifications and Evaluations

QUALIFICATIONS REQUIRED:
QUALIFICATIONS REQUIRED:
MINIMUM QUALIFICATIONS REQUIREMENTS:
A determination of your minimum qualifications will be based on the requirements listed below. You will be evaluated based upon the experience and/or education reflected in your resume. Please use clear and concise descriptions/examples when describing your experience. Applicants are 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.

Specialized Experience:
Specialized experience is described as experience that equipped the applicant with the particular knowledge, skills, and abilities to perform successfully the duties of the position, and that is typically in or related to the work of the position to be filled. Examples of specialized experience include:

Researching, gathering, and summarizing data and information, as well as other technical references and/or background materials. Conducting studies or projects and recommending solutions to address deficiencies; reviewing data for accuracy and making recommendations for problems identified; implementing, monitoring, reviewing, and evaluating policies and procedures; identifying and analyzing health care trends to determine the impact on program operations. Offers suggestions for administrative and other process improvements; composing routine and/or complex correspondence; inputting, manipulating, extracting data and utilizing databases to organize and retrieve data/ information. Work experience in an office setting using Microsoft applications. Excellent telephone etiquette and communication skills; demonstrated ability to communicate with the general public - orally and in writing.

Your current and/or previous experience must meet the level of difficulty and complexity of the GS-07 level in the Federal service and you must have performed at this level for at least fifty-two (52) weeks.

NOTE: If you are changing series and/or your position involves the performance of more than one type of work it is essential that approximate percentages of time be identified in your application. Describe your experience which will qualify you for this position as required by the specialized experience in this announcement. Failure to provide approximate percentages could impact your qualifications determination for this position.

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; or full credit has been given for the courses at a U.S. accredited college or university. For further information, visit: http://www.ed.gov/ .

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.

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 by 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 not be paid.

8. Bargaining Unit Position: Yes

9. Drug Screening Required: No

10. Recruitment Bonus may be authorized: No

HOW YOU WILL BE EVALUATED:
Once the application process is complete, a review of resume and supporting documentation will be made and compared against your responses to the assessment questionnaire to determine if you are qualified for this job. If, after reviewing your resume and or supporting documentation, a determination is made that you have inflated your qualifications and or experience, you may lose consideration for this position. Please follow all instructions carefully. Errors or omissions may affect your eligibility. Qualified candidates will be assigned to a quality category (Best-Qualified, Well-Qualified, and Qualified). The category assignment is a measure of the degree in which your background matches the competencies required for this position.

Qualified candidates assigned to a category are not given numeric ratings (scores); therefore, preference eligibles receive points, as prescribed by 5 U.S.C. § 3309.

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

Knowledge, skills, and abilities:
1. Knowledge of Medicare laws, regulations, and policies.

2. Ability to communicate orally.

3. Ability to communicate in writing.

4. Ability to conduct research.

You will be evaluated and rated under Category Rating and Selection procedures. Category rating combines the applicant's total qualifying experience and education/training into a single quality category. If you meet the basic qualification requirements, we will further evaluate your entire application package to determine the quality and extent of your experience, education, and training for placement in one of the following categories:

1. Best Qualified- Meets the Minimum Qualifications Requirements and received HHS Career system score between 95 to 100;

2. Well Qualified - Meets the Minimum Qualifications Requirements and receives a system score between 85 to 94.99;

3. Qualified - Meet the Minimum Qualifications Requirements and receives a system score between 70 to 84.99.

4. Not Qualified - Candidates who do not meet the Minimum Qualification Requirements as outlined in this vacancy announcement.

Applicant Scoring under HHS Careers: Your answers to the questions must be supported in your resume. Failure to do so will result in your scores being adjusted.

Benefits and Other Info

BENEFITS:
The Federal Government offers a comprehensive benefits package. Explore the major benefits offered to most Federal employees at http://www.usajobs.gov/ei/benefits.asp#icc .

OTHER INFORMATION:
If you are a veteran with preference eligibility and you are claiming 5-points veterans' preference, you must submit a copy of your DD-214 or other proof of eligibility. If you are claiming 10-point veterans' preference, you must also submit an SF-15, "Application for 10-Point Veterans' Preference" plus the proof required by that form. For more information on veterans’ preference see http://www.usajobs.gov/veterans.asp .

Males born after December 31, 1959 must be registered or exempt from Selective Service (see http://www.sss.gov ).

For information on "People with Disabilities" please visit http://opm.gov/disability/PeopleWithDisabilities.asp

Interagency Career Transition Assistance Program (ICTAP): For information on how to apply as an ICTAP eligible see http://opm.gov/rif/employee_guides/career_transition.asp#ictap . To be well-qualified and exercise selection priority for this vacancy, displaced Federal employees must be rated at 85.0 or above on the rating criteria for this position.

How To Apply

HOW TO APPLY:
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 DF428187. Fax your documents to 1-478-757-3144 .

If you cannot apply online:
Click the following link to view and print the assessment questionnaire View Occupational Questionnaire , and
Print this 1203FX form to provide your response to the assessment questionnaire http://www.opm.gov/forms/pdfimage/opm1203fx.pdf and
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.

The following documents are required and must be received by the closing date of this announcement:

1. Your Resume'
2. A complete Assessment Questionnaire

3. Other supporting documents:
  • Veterans Preference Documentation, if applicable
  • College transcript, if applicable
For Resume' and Application Tips visit: http://www.usajobs.gov/EI/resumeandapplicationtips.asp#icc

REQUIRED DOCUMENTS:
To apply for this position, you must provide a complete Application Package which includes:

1. Your Résumé

2. A complete Assessment Questionnaire

3. Other supporting documents :
  • Veterans Preference Documentation, if applicable
  • College Transcripts, if applicable
Note: You may submit an unofficial transcript or a list of college courses completed indicating course titles, credit hours, and grades received. An official transcript from an accredited educational institution is required if you are selected for the position.

The complete Application Package must be submitted by 11:59 PM (EST) on Friday, February 04, 2011.

AGENCY CONTACT INFO:
Elaine Jenkins

Phone: (301)492-4718

Email: ELAINE.JENKINS@HHS.GOV

Agency Information:
OHR Bethesda Operations Center

7700 Wisconsin Ave

Bethesda, MD 20814

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).

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