USAJOBS · 11 hours ago
Health Insurance Specialist (Program Contract Manager)
Woodlawn, Maryland, USA
Full-time
Onsite
Mid, Senior Level
$122K/yr - $158K/yr
1+ years expUSAJOBS is seeking a Health Insurance Specialist (Program Contract Manager) for the Department of Health & Human Services. In this role, you will be responsible for developing, evaluating, and implementing policies for Agency healthcare programs, while also proposing operational modifications based on industry changes and beneficiary needs.
ConsultingGovernmentHuman ResourcesInformation TechnologyInternetStaffing Agency
No H1B
U.S. Citizen Only
Responsibilities
Serve as an expert in the development, evaluation, and implementation of policies related to administering, reviewing and evaluating contracted stakeholders that participate in Agency health care delivery and quality or payment programs
Identify and propose modifications to operations to reflect changes or trends in the health care industry program objectives and needs of beneficiaries
Evaluate proposed, modified, or new legislation and regulations to assess impact on national health delivery, quality, or payment programs
Analyze internal policies, processes, and procedures to assure increased efficiency in operations and implement those policies, procedures, and processes to resolve problems and improve internal operations
Identify vulnerabilities in program requirements, implement instructions and guidelines to safeguarding program expenditures
Qualification
Required
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
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) Providing procurement planning, execution, monitoring and technical assistance for Contracting Officer Representative (COR) activities for a national healthcare program (i.e. Medicaid, CHIP, Marketplace); (2) Monitoring contractors who support national healthcare programs and maintain related databases, such as master utilization records and history files; (3) Conducting analytical studies by interpreting health care program issues related to contract administration functions; AND (4) Coordinating responses to government inquiries regarding health care program issues requiring corrective action plans
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
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
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.
Company
USAJOBS
USAJOBS enables federal job seekers to access job opportunities across hundreds of federal agencies and organizations.
10001+ employees
Funding
Current Stage
Late StageRecent News
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