If you are using the Office of Personnel Management's "Resume Builder" please be sure to follow all the instructions provided in this announcement. Addressing the Knowledge, Skills and Abilities (KSAs) is a very important process for this announcement
Announcement Number: RN3-04-040
Opening Date: October 5, 2004
Closing Date: October 19, 2004
Position Title, Series and Grade: Health Insurance Specialist, GS-107-09/11
Promotion Potential: None
Number of Vacancies: One Full-Time Permanent.
Annual Salary: $42,066 - $66,165 (Salary Reflects Locality Pay)
(See a full list of Job Benefits at http://www.cms.hhs.gov/careers/worklife/benefits.asp)
Organizational Location/Duty Station: Centers for Medicaid and Medicare Services (CMS), Division of Survey and Certification, Certification and Enforcement Branch, Region III, Philadelphia, PA
Shift & Tour of Duty: Full-time.
Area of Consideration (who may apply): All Qualified Persons
Summary of Duties: Incumbent provides technical and professional expertise in interpreting and applying policies, regulations and standards, reviewing and certifying new applicants, and processing recertification. Conducts field management evaluations and reviews to determine satisfactory State Agencies (SA) performance. Collaborates with other components of CMS and the Department in the enforcement of standards, certification of providers, agency clearances, and fraud and abuse investigations. Reviews initial certification, recertification, non-renewal and termination packets. Uses program management data to assess and control the timeliness and adequacy of SA recertification actions. Participates in periodic State and Federal surveys of certified providers. Participates in the development of Regional policy, procedures and guidelines for certification activities and evaluates their effectiveness.
MINIMUM QUALIFICATION REQUIREMENTS: Please note that qualification requirements must be met by the closing date of this announcement. Applicants are advised that all information concerning qualifications is subject to investigation. False representation may be grounds for nonconsideration, nonselection and/or appropriate disciplinary action.
Specialized Experience: Fifty-two (52) weeks of specialized experience equivalent to at least the GS-7 grade level – for the GS-09 and at least at the GS-09 grade level – for the GS-11 or and must have career or career-conditional status.
GS-09 and GS-11: Specialized experience is experience performing work concerned with the administration and operation of health insurance programs, such as Medicare and Medicaid. This could include experience such as interpreting health insurance program requirements and formulating policies, methods and procedures; monitoring, reviewing, evaluating and assessing the integrity and quality of health insurance program operations; preparing and analyzing health care data related to health insurance programs; activities related to health care research such as evaluation and/or experimental proposals to support the development, implementation, and refinement of health insurance payment and delivery systems; or performing other related activities.
Substitution of Education for Experience:
At the GS-09 grade level, an applicant may substitute education for experience if the applicant has earned a Master’s or equivalent degree or two (2) full years of progressively higher-level graduate education leading to such a degree.
At the GS-11 grade level, an applicant may substitute education for experience if the applicant has earned a Ph.D. or equivalent doctoral degree or three (3) full years of progressively higher-level graduate education leading to such as degree.
RATING CRITERIA – Knowledge, Skills and Abilities (KSAs): What are your knowledge, skills and abilities as they relate to this position? In addition to your resume, please write 1/2 to 1 page narrative statement explaining the experience you have relating to each KSA listed below. (Instructions for addressing KSAs can be found at http://www.cms.hhs.gov/careers/apply/ksa.asp)
Evaluation Method: Applicants who meet the qualification requirements will be further evaluated by determining the extent to which their work or related experience, education, training, awards, outside activities and/or supervisory appraisal (a copy of your most recent performance appraisal may be required), etc., indicate they possess the knowledge, skills and abilities (KSAs). Applicants will not receive credit by merely paraphrasing the task examples. All applicants should provide clear, concise examples that show level of accomplishment or degree to which they possess the KSAs. The information provided will be used to determine the "best qualified" candidates.
To receive consideration, all applications must include the Announcement Number and must be received by this office, or postmarked on or before the closing date and be received within five (5) days after the closing date of this announcement. Failure to submit all required forms may constitute an incomplete application resulting in the applicant not receiving consideration. If applicable to this announcement, it is the applicant’s responsibility to provide documentation/proof of claimed qualifications, education, veteran’s preference, status (SF-50) and/or verification of eligibility for noncompetitive appointment.
Submit your application to: DHHS/Centers for Medicare & Medicaid Services, Baltimore Human Resources Center (BHRC), P.O. Box 8001, Baltimore, MD 21244-9001. If you are using an express mail service that does not deliver to a post office box, you may mail your application materials to DHHS/BHRC, C2-08-13, 7500 Security Boulevard, Baltimore, MD 21244. Resumes may be faxed to (410) 786-0728, or E-mailed to CMSResume@cms.hhs.gov. Please be aware that for security reasons visits to our Baltimore location are restricted and that personal delivery of applications is not recommended. CMS assumes no responsibility for the delivery of applications. It is the responsibility of the applicant to ensure timely receipt of his/her application regardless of the method used.
Applications mailed using Government postage and/or internal Federal Government mail systems are in violation of Agency and postal regulations and will not be accepted.
For further information contact: Sonamiata Butler at (410) 786-2563 or (800) 735-2258 for hearing impaired applicants.
Recent events have affected mail delivery; therefore, when submitting your application, you may want to consider using express mail delivery services if you do not have access to E-mail or fax capabilities. You may call the numbers listed below to ensure that your expressed-mailed or regularly-mailed application was received.
Information on certain aspects of employment as well as job opportunities with the Federal government can be found on the Office of Personnel Management (OPM) Web site http://www.usajobs.opm.gov/b.htm. A listing of current job opportunities here at CMS can be found at http://www.cms.hhs.gov/careers/rns/. For answers to frequently asked questions relating to human resources go to http://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_alp.php?p_cat_lvl1=17.
Information to Include in Your Resume:
A. Job Information: Complete announcement number, title and
grade(s) of the job for which you are applying.
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B. Personal Information:
a) Full name
b) Mailing address (with zip code)
c) Day and evening phone numbers (with area codes)
d) Social Security Number
e) Country of Citizenship
f) Veteran's Preference: To claim a 5-point veteran's preference, attach a copy of your DD-214, Certificate of Release or Discharge from Active Duty; to claim a 10-point veteran's preference, attach an SF-15, Application for 10-Point Veteran's Preference, plus the proof required by the SF-15 (obtain a copy of the SF-15 from http://www.opm.gov/forms/word/sf15.doc). Applicants must clearly identify veteran's preference on their application.
g) Reinstatement Eligibility (include copy of last Notification of Personnel Action, SF-50)
h) Highest Federal civilian grade held (also give job series and dates held)
i) Types of Federal civilian appointments held: Temporary, Term, Career-Conditional, Career, and/or Excepted.
C. Education:
a) High school: name, city, and state (zip code if known), and date of diploma or GED.
b) Colleges and universities: name, city, and state of school(s) attended; major(s); type and year of any degrees received. (If no degree has been awarded, provide total credits earned and whether semester or quarter hours.) Send a copy of your college transcript if education is being substituted for experience and/or is required for this vacancy.
D. Work Experience: Give the following information for your paid and unpaid work experience related to the job for which you are applying: a) job title, including series and grade if a Federal job; b) duties and accomplishments; c) employer's name and address; d) supervisor's name and phone number; e) starting and ending dates (month, day, and year); f) hours per week; and g) salary. Please indicate if we may contact your current supervisor.
E. Other Qualifications: Please indicate any of the following you may have that are job related: a) training courses (title, month and year, and length of training), b) skills such as other languages, computer software/hardware knowledge, typing speed, etc.; c) certificates and licenses (current only), and d) honors, memberships in professional or honor societies, and awards.
Other Information:
Persons who are eligible under special hiring/appointment authorities (e.g., 30% compensable veterans, individuals with severe physical disabilities, former Peace Corps, VISTA Volunteers, and VRA (VRA appointments may only at the GS-11 level or below – promotion potential of the position is not a factor) are also encouraged to apply. Applicants eligible under these special placement programs must indicate on the front of their resume the program under which they are applying and MUST submit proof of eligibility. Applicants who wish to be considered under a special hiring authority as well as under the competitive examining process MUST submit two resumes. When only one resume is received it will be considered for the appropriate special hiring authority.
Applicant MUST be a U.S. citizen. Male applicants born after December 31, 1959, MUST be registered with the Selective Service system or MUST certify that they are exempt from having to do so under the Selective Service Law. All Federal employees are required by Public Law 104-134 to have Federal payments made by "direct deposit."
This Agency provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please notify the Agency. The decision on granting reasonable accommodation will be on a case-by-case basis.
Any U.S. Public Health Service (PHS) Commissioned Corp Officer interested in performing the duties of the position as a Commissioned Corp Officer MUST indicate this interest on his/her resume. Failure to indicate interest to remain within the Commissioned Corps will result in the resume being considered through competitive service examining procedures.
NOTE: Commissioned Officers are expected to have completed 2 years at their current duty station before accepting a new assignment.
Priority Consideration for Surplus or Displaced Federal Employees:
Individuals who have special priority selection rights under the Agency Career Transition Assistance Program (CTAP) or the Interagency Career Transition Assistance Program (ICTAP) must be well qualified for the position to receive consideration for special priority selection. CTAP and ICTAP eligibles will be considered well qualified if they attain a rating of above average on all KSAs as well as meet any selective placement factors. CTAP and ICTAP eligibles that are rated well qualified may be subject to an interview.
Federal employees seeking CTAP/ICTAP eligibility must submit proof that they meet the requirements of 5 CFR 330.605(a) for CTAP and 5 CFR 330.704 for ICTAP. This includes a copy of the Agency notice, a copy of their most recent Performance Rating and a copy of their most recent SF-50 noting current position, grade level, and duty location. Please annotate your resume to reflect that you are applying as a CTAP or ICTAP eligible.
Requires a background investigation.
Frequent travel may be required: No (X) Yes ( )
Requires a New Appointment Probationary Period: No ( ) Yes (X)
Note: Current Federal employees may be required to serve a new probationary period.
Requires Annual Financial Disclosure Statement: No (X) Yes ( )
Relocation Expenses: May ( ) will not (X) be paid. (NOTE: If you receive relocation expenses you must agree to remain in the Federal Government’s service for a period of 12 months from the date you report to duty at your official duty station. If you fail to remain in the Federal Government’s service you will be required to repay any monies expended from Federal funds for travel, transportation, and relocation expenses, unless separated for reasons beyond your control and acceptable to CMS.)
Resumes mailed using Government postage and/or internal Federal Government mail systems are in violation of Agency and postal regulations and will not be accepted.
All candidates will receive consideration for this position without regard to race, color, religion, sex, age, national origin, disability, political affiliation, marital status, or other non-merit factor.