Skip to main content
U.S. flag
Back to results

Health Insurance Specialist

Department of Health and Human Services
Centers for Medicare & Medicaid Services
Office of Program Operations and Local Engagement (OPOLE)
This job announcement has closed

Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Office of Program Operations and Local Engagement (OPOLE), Medicare Plan Management Group (MPMG).

As a Health Insurance Specialist, GS-0107-14, you will assess a wide range of qualitative and quantitative issues and studies that relate to the Medicare program's effectiveness, efficiency, and/or improvement.

Overview

Help
Reviewing applications
Open & closing dates
09/29/2025 to 10/03/2025
Salary
$142,488 to - $185,234 per year
Pay scale & grade
GS 14
Location
1 vacancy in the following location:
Boston, MA
Remote job
No
Telework eligible
Yes—as determined by the agency policy.
Travel Required
25% or less - You may be expected to travel up to 20% for this position.
Relocation expenses reimbursed
No
Appointment type
Permanent
Work schedule
Full-time
Service
Competitive
Promotion potential
14
Supervisory status
No
Security clearance
Not Required
Drug test
No
Position sensitivity and risk
Moderate Risk (MR)
Trust determination process
Financial disclosure
No
Bargaining unit status
Yes
Announcement number
CMS-OPOLE-25-12803707-IMP
Control number
846673000

This job is open to

Help

Clarification from the agency

Career Transition Assistance Plan Eligibles; OR Current Permanent Career and Career-Conditional Employees in CMS, Office of Program Operations and Local Engagement (OPOLE), in Boston, MA

Videos

Duties

Help
  • Develop and coordinate the work of program task forces and work groups on cross program issues and problems and present impact analysis and recommendations to senior MPMG/MCSG, DHPO and OPOLE managers.
  • Conduct studies to ensure consistency and the elimination of unnecessary duplication of effort and cost between program activities.
  • Perform or lead national studies, reviews, evaluations, and/or projects that directly impact upon Group’s Medicare program area(s) across the country.
  • Analyze and implement methods for ensuring that uniform application of program policies and regulations is consistent throughout the Group.
  • Participate in and make key authoritative contributions to top-level discussions and planning sessions on Medicare program policy development. Coordinate and follow up on assignments in the management and administration of work projects.

Requirements

Help

Conditions of employment

  • You must be a U.S. Citizen or National to apply for this position.
  • You will be subject to a background and suitability investigation.
  • Time-in-Grade restrictions apply.

Qualifications

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) Performing program management functions that include policy, operations, and evaluation aspects of Medicare, Medicaid, or other health insurance programs;
2) Executing detailed analyses of health care program activities addressing areas of deficiency; AND
3) Planning and conducting comprehensive projects or studies outlining proposed recommendations based on findings.

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/12803707

Education

This job does not have an education qualification requirement.

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 Interagency Career Transition Assistance Plan (ICTAP) and 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 ICTAP and CTAP eligibility is on OPM's Career Transition Resources website at www.opm.gov/rif/employee_guides/career_transition.asp.

Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.

How you will be evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

You will be evaluated based on how well you meet the qualifications listed in this vacancy announcement. Your qualifications will be evaluated based on your application materials (e.g., resume, supporting documents), the responses you provide on the application questionnaire, and the results of the online assessments required for this position. Please follow all instructions carefully. Errors or omissions may affect your rating.

You will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics):

  • Attention to Detail
  • Customer Service
  • Decision Making
  • Flexibility
  • Influencing/Negotiating
  • Integrity/Honesty
  • Interpersonal Skills
  • Learning
  • Reading Comprehension
  • Self-Management
  • Stress Tolerance
  • Teamwork


In order to be considered for this position, you must complete all required steps in the process. In addition to the application and application questionnaire, this position requires an online assessment. The online assessment measures critical general competencies required to perform the job.

The assessment includes a cut score based on the minimum level of required proficiency in these critical general competencies. You must meet or exceed the cut score to be considered. You will not be considered for the position if you score below the cut score or fail to complete the assessment.

Overstating your qualifications and/or experience in your application materials or application questionnaire may result in your removal from consideration. Cheating on the online assessment may also result in your removal from consideration.

Your session is about to expire!

Your USAJOBS session will expire due to inactivity in 8 minutes. Any unsaved data will be lost if you allow the session to expire. Click the button below to continue your session.