Talent.com
Supervisory Health Insurance Specialist
Supervisory Health Insurance SpecialistMaryland Staffing • Gwynn Oak, MD, US
Supervisory Health Insurance Specialist

Supervisory Health Insurance Specialist

Maryland Staffing • Gwynn Oak, MD, US
24 days ago
Job type
  • Permanent
Job description

Supervisory Health Insurance Specialist Position

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare, Division of Encounter Data & Risk Adjustment Operations. As a Supervisory Health Insurance Specialist, GS-0107-14, you will provide leadership in the directing, planning, overseeing, and administration of key national program policies and procedures, as they relate to the Encounter Data and other Risk Adjustments Data collection.

Responsibilities :

  • Direct experience with overseeing the operations of the CMS encounter data and risk adjustment systems.
  • Expertise with data collection systems that collect at least 1 billion records annually.
  • Has served for at least one year as a manager / supervisor of a team with at least 7 other lower-graded team members.
  • Experience reviewing, writing, and researching portions of CMS' annual rulemaking related to both the Medicare Part C and D programs.

Requirements :

Conditions of Employment :

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 :
  • Providing technical leadership in the development, operations, and improvement of Medicare Advantage encounter data systems.
  • Experience in federal contracting to support high dollar IT and data analysis contracts related to large-scale data systems.
  • Experience analyzing critical legislative, regulatory, policy, and operational initiatives related to Medicare Advantage to assess the operational impact to data systems and business processes.
  • Directing teams to manage sophisticated, large-scale data collection systems, including analyzing and developing business requirements and guidance documents.
  • Lead or direct communication with health plans, providers, or stakeholders on a range of complex operational issues related to large-scale data collection for public programs.
  • 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.
  • Additional Information :

    Bargaining Unit Position : No

    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. 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.

    Create a job alert for this search

    Insurance Specialist • Gwynn Oak, MD, US

    Related jobs
    High Risk Life Insurance Agent

    High Risk Life Insurance Agent

    Team Nexa Insurance Solutions • Baltimore, MD, US
    Full-time
    Quick Apply
    APPLICANTS MUST HOLD A VALID LIFE INSURANCE PRODUCER'S LICENSE This Is for High Risk Clients with Health Issues Day 1 Coverage for Many APPLICANTS MUST BE IN THE UNITED STATES This is both an Engli...Show more
    Last updated: 30+ days ago
    Client Service Specialist

    Client Service Specialist

    Affinity Group • New Freedom, PA, US
    Full-time
    Quick Apply
    Provide continuous service to the clients, customers, and personnel of Affinity Group.Utilizes technology to place orders, maintain systems / financials, file documents and communicate information.Ac...Show more
    Last updated: 30+ days ago
    Documentation Support Specialist- Temporary Role

    Documentation Support Specialist- Temporary Role

    TridentCare • Sparks Glencoe, MD, United States
    Full-time
    Organize, scan, and appropriately manage inbound responses to patient medical record requests to support compliance audits, organizational risk assessments, and ongoing monitoring activities.Respon...Show more
    Last updated: 30+ days ago • Promoted
    Provider Contracting Specialist - (Remote)

    Provider Contracting Specialist - (Remote)

    CareFirst BlueCross BlueShield • Baltimore, MD, United States
    Remote
    Full-time
    Live in CareFirst service area).This role will lead, guide, strategize and manage negotiations for provider-specific institutional, ancillary, and professional contracts. Key responsibilities includ...Show more
    Last updated: 30+ days ago • Promoted
    Medical Technologist / Point-of-Care (POC) / MLT) - Full-time Night Shift

    Medical Technologist / Point-of-Care (POC) / MLT) - Full-time Night Shift

    WellSpan Hospitals in Carlisle, Newberry & Shrewsbury • New Freedom, PA, United States
    Full-time
    Medical Technologist / Point-of-Care (POC) / MLT).Small-Format Hospital (10 ER, 10 Inpatient).Night / Weekend shift differentials, 401K MATCH (100% vested day ONE after the eligibility period has been me...Show more
    Last updated: 30+ days ago • Promoted
    Medical Director (Southern CA)

    Medical Director (Southern CA)

    Molina Healthcare • MD, United States
    Full-time
    Provides medical oversight and expertise in the appropriateness and medical necessity of services provided to members, targeting improvements in efficiency and satisfaction for both members and pro...Show more
    Last updated: 3 days ago • Promoted
    BILLING SPECIALIST

    BILLING SPECIALIST

    LifeBridge Health • Owings Mills, MD, United States
    Full-time
    This position is responsible for accurately reviewing and / or correcting medical billing data for claims submission to insurance companies. Resolves BAR claim edits and payer rejections.Obtains and s...Show more
    Last updated: 15 days ago • Promoted
    Claim Analyst II (Nursing Specialist II)

    Claim Analyst II (Nursing Specialist II)

    J29, Inc • Millersville, MD, US
    Full-time
    Quick Apply
    Claims Analyst II (Nursing Specialist II) Overview : .J29 is an employee-centered healthcare management consulting company that specializes in processing, reviewing, and analyzing medical claims, rec...Show more
    Last updated: 9 days ago
    Travel Cath Lab Tech in Fountainhead-Orchard Hills, MD - $13458 / month

    Travel Cath Lab Tech in Fountainhead-Orchard Hills, MD - $13458 / month

    VETTED • Maryland Line, MD, United States
    Temporary
    Job Opportunity : Cath Lab Tech.Location : Hagerstown, Maryland.Provides specialized healthcare services in a clinical setting. Works collaboratively with healthcare team members.Maintains professiona...Show more
    Last updated: 4 days ago • Promoted
    Insurance Operations Associate

    Insurance Operations Associate

    Risk Strategies • Sparks Glencoe, MD, United States
    Full-time
    The Insurance Operations Associate provides support to the administrative team by performing essential clerical tasks and assisting with daily operations. This role focuses on ensuring the smooth fu...Show more
    Last updated: 27 days ago • Promoted
    Senior Actuary

    Senior Actuary

    DataAnnotation • MD, United States
    Full-time +1
    We are looking for a Senior Actuary to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of each m...Show more
    Last updated: 13 days ago • Promoted
    Health Coach, Enrollment (Bilingual / Multilingual)

    Health Coach, Enrollment (Bilingual / Multilingual)

    Scene Health • Baltimore, MD, US
    Full-time
    Quick Apply
    Health Coach, Enrollment (Bilingual / Multilingual) Scene’s 360° model of care enhances the gold standard of medication adherence, Directly Observed Therapy.Combining personalized ...Show more
    Last updated: 10 days ago
    Behavioral Health Medical Biller

    Behavioral Health Medical Biller

    Pleasant Behavioral Health Systems • Pikesville, Maryland, United States
    Full-time
    Quick Apply
    CANDIDATES MUST RESIDE IN MARYLAND ONLY!.The Medical Billing Specialist files timely and complete appeals electronically, telephonically, or manually in accordance with payer guidelines.Using a tho...Show more
    Last updated: 4 days ago
    Quality Specialist - Northeast Region (Corporate Quality Team)

    Quality Specialist - Northeast Region (Corporate Quality Team)

    Trescal Inc • 21152, MD, US
    Full-time
    We are the premier independent calibration, repair, and asset services provider in the U.We provide our customers single-source, cost-effective, best-in-class solutions. Our team is comprised of tal...Show more
    Last updated: 30+ days ago • Promoted
    Human Resources Intern

    Human Resources Intern

    First Financial Federal Credit Union of Maryland • 21152, MD, US
    Full-time +1
    First Financial Federal Credit UnionJob Description.Administrative Support Workers.Telework Work Possible (if checked).See Telework Policy for Additional Criteria. The HR Intern will support a wide ...Show more
    Last updated: 14 days ago • Promoted
    Health Information Management Specialist

    Health Information Management Specialist

    Greater Baltimore Medical Center (GBMC) • Hunt Valley, MD, United States
    Full-time
    Under direct supervision, maintains a comprehensive medical record consistent with all federal, state and company policies and procedures, and performs general secretarial duties to support their a...Show more
    Last updated: 27 days ago • Promoted
    Healthcare Superintendent

    Healthcare Superintendent

    Corenic Construction Group • Largo, MD, US
    Full-time
    Quick Apply
    Corenic Construction Group , a leader in the Washington, DC construction industry, and named 2025 Business of the Year by the DC Chamber of Commerce is seeking talent for their corporate offi...Show more
    Last updated: 30+ days ago
    Revenue Cycle Senior Manager

    Revenue Cycle Senior Manager

    West Cecil Health Center • White Hall, MD, United States
    Full-time
    West Cecil Health Center (WCHC) is seeking a dedicated Revenue Cycle Senior Manager to join our team.WCHC is a thriving nonprofit, community health organization that provides comprehensive and coll...Show more
    Last updated: 4 days ago • Promoted