Center for Medicare (DOHHS)
Supervisory Health Insurance Specialist
Center for Medicare (DOHHS), Washington, District of Columbia, us, 20022
Summary
This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare (CM), Medicare Plan Payment Group (FCHK). As a Supervisory Health Insurance Specialist, GS‑0107, you will serve as the Deputy Group Director for Policy, Strategy, and Analysis, responsible for directing and managing the goals and objectives of the organization.
Overview
Open & closing dates: 11/03/2025 to 11/07/2025
Salary range: $167,603 to $195,200 per year
Pay grade: GS 15
Locations: Washington, DC; Woodlawn, MD
Remote job: No
Telework eligible: Yes—as determined by the agency policy.
Travel required: Occasional travel – You may be expected to travel up to 5% for this position.
Relocation expenses reimbursed: No
Appointment type: Permanent
Work schedule: Full‑time
Service: Competitive
Promotion potential: 15
Series: 0107 Health Insurance Administration
Supervisory status: Yes
Security clearance: Not Required
Drug test: No
Position sensitivity and risk: High Risk (HR) – Trust determination process
Credentials: Credentialing; Suitability/Fitness
Financial disclosure: Yes
Bargaining unit status: No
Announcement number: CMS‑CM‑26‑12806608‑IMP
Control number: 849204800
Duties
Serve as an expert resource and technical authority on prescription drug and MA payment related issues, policies, strategy, and analysis, including national payment policy, bidding policy, and risk adjustment policy.
Generate and apply new concepts in planning, conducting, evaluating, and developing solutions for complex payment policies in MA and the Part D program that will assist decision makers.
Supervise and direct subordinate staff as a first‑line manager, providing administrative, policy, and program objectives, assigning tasks, and evaluating the work directed; evaluate subordinates’ work products and performance.
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.
Providing technical leadership in the development and improvement of Medicare Advantage (MA) and Medicare prescription drug plan (Part D) payment policy, strategy, or data analysis.
Briefing White House and congressional officials, as well as other internal and external stakeholders, on Medicare Advantage (MA) and Medicare prescription drug plan (Part D) payment policies and analysis.
Conducting analysis of Medicare Advantage (MA) and Medicare prescription drug plan (Part D) bids and presenting results of the bid analysis to executive leadership.
Leading teams in the development and refinement of Medicare Advantage (MA) and Medicare prescription drug plan (Part D) risk adjustment models and related topics, including coding intensity.
Writing or overseeing the development of regulations on the topics of Medicare Advantage (MA) and Medicare prescription drug plan (Part D) program payment policies.
Volunteer experience is also considered for qualifying experience. You will receive credit for all qualifying experience, including volunteer experience.
Time‑in‑Grade:
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.
Visit https://apply.usastaffing.gov/ViewQuestionnaire/12806608 for the occupational questionnaire.
Education This job does not have an education qualification requirement.
Additional information Bargaining Unit Position:
No
Tour of Duty:
Flexible
Recruitment Incentive:
Not Authorized
Relocation Incentive:
Not Authorized
Financial Disclosure:
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.
Benefits A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding.
Learn more about federal benefits.
Required documents
Resume:
show relevant experience; cover letter optional. Your resume must indicate citizenship and, if required, selective service registration. Include work experience, education, dates, and hours per week. For federal service, include series and grade level.
CMS Required Documents:
Current CMS employees must submit a copy of their most recent Notification of Personnel Action (SF‑50) at the time of application.
Reasonable Accommodation Requests:
Submit requests before starting assessments. Follow instructions on the USA Hire site.
How to Apply Please read the entire announcement and all instructions before you begin an application. To apply and be considered for this position, you must complete all required questionnaires, assessments and submit all required documentation as specified. The complete application package must be submitted by 11:59 PM (ET) on 11/07/2025.
After submitting, you will be notified of any required USA Hire assessments. Complete those assessments within the specified deadlines. Maintain all application materials in your USAJOBS account and edit your application if necessary until the announcement closes.
Agency contact information Email: hrinquiries@cms.hhs.gov
Address:
Center for Medicare 7500 Security Blvd Woodlawn, MD 21244 US
Next steps After you submit your application, we will review your qualifications and, if selected, provide instructions on how to access the USA Hire system for online assessments. Assessment results will remain on record for one year and may be used for future positions requiring the same assessments.
Fair and transparent We are committed to a fair and transparent hiring process. EEO, privacy, and other compliance policies apply. For more information, refer to the relevant federal guidelines.
#J-18808-Ljbffr
Overview
Open & closing dates: 11/03/2025 to 11/07/2025
Salary range: $167,603 to $195,200 per year
Pay grade: GS 15
Locations: Washington, DC; Woodlawn, MD
Remote job: No
Telework eligible: Yes—as determined by the agency policy.
Travel required: Occasional travel – You may be expected to travel up to 5% for this position.
Relocation expenses reimbursed: No
Appointment type: Permanent
Work schedule: Full‑time
Service: Competitive
Promotion potential: 15
Series: 0107 Health Insurance Administration
Supervisory status: Yes
Security clearance: Not Required
Drug test: No
Position sensitivity and risk: High Risk (HR) – Trust determination process
Credentials: Credentialing; Suitability/Fitness
Financial disclosure: Yes
Bargaining unit status: No
Announcement number: CMS‑CM‑26‑12806608‑IMP
Control number: 849204800
Duties
Serve as an expert resource and technical authority on prescription drug and MA payment related issues, policies, strategy, and analysis, including national payment policy, bidding policy, and risk adjustment policy.
Generate and apply new concepts in planning, conducting, evaluating, and developing solutions for complex payment policies in MA and the Part D program that will assist decision makers.
Supervise and direct subordinate staff as a first‑line manager, providing administrative, policy, and program objectives, assigning tasks, and evaluating the work directed; evaluate subordinates’ work products and performance.
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.
Providing technical leadership in the development and improvement of Medicare Advantage (MA) and Medicare prescription drug plan (Part D) payment policy, strategy, or data analysis.
Briefing White House and congressional officials, as well as other internal and external stakeholders, on Medicare Advantage (MA) and Medicare prescription drug plan (Part D) payment policies and analysis.
Conducting analysis of Medicare Advantage (MA) and Medicare prescription drug plan (Part D) bids and presenting results of the bid analysis to executive leadership.
Leading teams in the development and refinement of Medicare Advantage (MA) and Medicare prescription drug plan (Part D) risk adjustment models and related topics, including coding intensity.
Writing or overseeing the development of regulations on the topics of Medicare Advantage (MA) and Medicare prescription drug plan (Part D) program payment policies.
Volunteer experience is also considered for qualifying experience. You will receive credit for all qualifying experience, including volunteer experience.
Time‑in‑Grade:
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.
Visit https://apply.usastaffing.gov/ViewQuestionnaire/12806608 for the occupational questionnaire.
Education This job does not have an education qualification requirement.
Additional information Bargaining Unit Position:
No
Tour of Duty:
Flexible
Recruitment Incentive:
Not Authorized
Relocation Incentive:
Not Authorized
Financial Disclosure:
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.
Benefits A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding.
Learn more about federal benefits.
Required documents
Resume:
show relevant experience; cover letter optional. Your resume must indicate citizenship and, if required, selective service registration. Include work experience, education, dates, and hours per week. For federal service, include series and grade level.
CMS Required Documents:
Current CMS employees must submit a copy of their most recent Notification of Personnel Action (SF‑50) at the time of application.
Reasonable Accommodation Requests:
Submit requests before starting assessments. Follow instructions on the USA Hire site.
How to Apply Please read the entire announcement and all instructions before you begin an application. To apply and be considered for this position, you must complete all required questionnaires, assessments and submit all required documentation as specified. The complete application package must be submitted by 11:59 PM (ET) on 11/07/2025.
After submitting, you will be notified of any required USA Hire assessments. Complete those assessments within the specified deadlines. Maintain all application materials in your USAJOBS account and edit your application if necessary until the announcement closes.
Agency contact information Email: hrinquiries@cms.hhs.gov
Address:
Center for Medicare 7500 Security Blvd Woodlawn, MD 21244 US
Next steps After you submit your application, we will review your qualifications and, if selected, provide instructions on how to access the USA Hire system for online assessments. Assessment results will remain on record for one year and may be used for future positions requiring the same assessments.
Fair and transparent We are committed to a fair and transparent hiring process. EEO, privacy, and other compliance policies apply. For more information, refer to the relevant federal guidelines.
#J-18808-Ljbffr