Health Insurance Specialist

Cms

$80K — $95K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 5-7 years of specialized experience related to Medicare call center operations
  • Experience in data analysis and developing operational strategies
  • Knowledge of contractor performance monitoring and communications policies
  • Ability to represent CMS in vendor meetings and negotiate requirements
  • Experience in developing procedures to enhance customer service

Responsibilities

  • Develop integrated national strategies for Medicare customer service
  • Analyze operational data to identify trends and inform policy development
  • Represent CMS in meetings with vendors to ensure telecommunication needs are met
  • Create procedures to improve services for Medicare beneficiaries via phone
  • Manage program activities for 1-800-MEDICARE call center operations

Benefits

  • Comprehensive benefits package for federal employees
  • Access to flexible work arrangements and alternative schedules
  • Support for career transition through ICTAP and CTAP eligibility
  • Opportunity for professional development and training
  • Health insurance and retirement benefits included
Full Job Description
Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Office of Communications (OC).

As a Health Insurance Specialist, GS-0107-13, you will develop, implement, and manage requirements for the national Medicare toll-free telephone service contractors, including 1-800-MEDICARE call center operations.

Duties

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  • Develops integrated national strategies, tools, and techniques for improving telephone and Medicare beneficiary customer services.
  • Analyzes Call Center and Medicare beneficiary customer service operational data so as to establish trends and best practices for use in the development of national policies, legislation, reports, presentations, and briefings.
  • Represents CMS at meeting with telecommunications vendors, software vendors, hardware vendors, Medicare contractors, and other government agencies to assure that CMS's telecommunication requirements are understood and met.
  • Develops procedures for improving beneficiary services for telephone contacts with Medicare customers.


Requirements

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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.
  • Selective Service: Males born after December 31, 1959, must be registered or exempt from Selective Service - http://www.sss.gov.
  • One-year probationary period may be required.
  • 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.
  • All Federal employees are required to have Federal salary payments made by direct deposit to a financial institution of their choice.


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, developing, evaluating, or implementing call center program activities; 2) monitoring the performance or work products of contractor employees; and 3) developing or modifying call center communications policies or procedures.

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/[redacted]

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.

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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.

Benefits

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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. Opens in a new windowLearn more about federal benefits.

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Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.

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