Health Insurance Specialist

About the role

Department of Health & Human Services, Centers for Medicare & Medicaid Services, Center for Medicaid and CHIP Services, Financial Management Group (FMG), Division of Reimbursement Policy (DRP).

As a Health Insurance Specialist, GS-0107-14, provides technical direction and leadership to a highly technical professional staff; and develops, implements, and evaluates Medicaid payment policies for services provided to Medicaid beneficiaries in institutional and non-institutional settings.

What you will do

• Providing technical direction and leadership to a highly technical professional staff; and develops, implements, and evaluates Medicaid payment policies for services provided to Medicaid beneficiaries in institutional and non-institutional settings.
• Providing technical direction and leadership to a highly technical professional staff; and develops, implements, and evaluates Medicaid payment policies for services provided to Medicaid beneficiaries in institutional and non-institutional settings.
• Providing technical assistance to staff, States, contractors, etc., to resolve problems by participating in meetings, answering inquiries, going on-site, doing special analyses, providing training, refining instructions, etc. Serving as a technical management and team lead for Medicaid and CHIP operations, planning and coordinating activities related to Medicaid financial management oversight.

How you will be evaluated

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.

A Subject Matter Expert will assist in the resume review process to help determine whether you meet the minimum job qualifications. 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. 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.

Documents you must provide

• To apply for this position, you must submit a complete Application Package which includes: 1.
• Resume showing relevant experience; cover letter optional.
• NOTE: As of September 27, 2025, federal agencies will only accept resumes that are two pages or less in length.
• Your resume must indicate your citizenship and whether you are registered with the Selective Service if you are a male born after December 31, 1959.
• Your resume must also list your work experience and education (if applicable), including the start and end dates (mm/yyyy) of each employment, along with the number of hours worked per week.
• For work in the Federal service, you must include the series and grade level for the position(s).
• Your resume will be used to validate your responses to the assessment tool(s).
• For resume and application tips, visit: ***
• CMS Required Documents (e.g., SF-50, DD-214, SF-15, etc.).
• Current CMS employees are REQUIRED to submit a copy of their most recent Notification of Personnel Action (SF-50) at the time of application.
• Additional documents may also be required to be considered for this vacancy announcement.
• Click here for a detailed description of the required documents.
• Failure to provide the required documentation WILL result in an ineligible rating OR non-consideration.
• Although this position does not require a degree, you may substitute college credit in whole or in part for experience at specified grade levels.
• You must submit a copy of your transcript at the time of application in order to substitute your education for the required experience.
• If you do not submit a transcript, your education will not be considered in determining your qualifications for the position.
• You may submit an unofficial transcript or a list of college courses completed, indicating course title, credit hours, and grades received.
• An official transcript is required if you are selected for the position.
• College Transcripts and Foreign Education: Applicants who have completed part or all of their education outside the U.S. must have their foreign education evaluated by an accredited organization to ensure that it is comparable to the education received in accredited educational institutions in the U.S. For a listing of services that can perform this evaluation, visit the National Association of Credential Evaluation Services website.
• This list, which may not be all-inclusive, is for informational purposes only and does not imply any endorsement of any specific agency.
• If you are applying for a position for which a state license is issued (e.g., physician, engineer, attorney), possession of a valid and current U.S. professional license by a graduate of a foreign professional school or program is sufficient proof that the foreign education has been determined to be equivalent to the requisite U.S. professional education in that occupational field.
• Reasonable Accommodation (RA) Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended, that would interfere with completing the USA Hire Competency-Based Assessments, you will be granted the opportunity to request a RA in your online application.
• Requests for RA for the USA Hire Competency-Based Assessments and appropriate supporting documentation for RA must be received prior to commencing the USA Hire Competency-Based Assessments.
• Decisions on requests for RA are made on a case-by-case basis.
• If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency-Based Assessments, based on your adjudication decision.
• You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency-Based Assessments if you received the link after the close of the announcement.
• To determine if you need an RA, please click here to review the Procedures for Requesting a Reasonable Accommodation for Online Assessments.
• PLEASE NOTE: A complete application package includes the online application, resume, and CMS required documents.
• Please carefully review the full job announcement, which includes the "Required Documents" and "How to Apply" sections.
• Failure to submit the online application, resume, and CMS required documents will result in your not being considered for employment.

What to expect next

Based on your application and your responses to the application questionnaire, you may be presented with instructions on how to access the USA Hire system to complete the online assessments. The online assessments must be completed within 48 hours following the close of this announcement.

You will have the opportunity to request a testing accommodation for the assessment should you have a disability covered under the Americans with Disabilities Act (ADA). Your assessment results will be kept on record for one year and used toward future positions for which you might apply that require the same assessments.

Within 30 business days of the closing date, 09/23/2026, you may check your status online by logging into your USAJOBS account (***). We will update your status after each key stage in the application process has been completed.

Additional information

Bargaining Unit Position: Yes 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 ***