Health Insurance Specialist

Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Clinical Standards and Quality,(CCSQ) Survey and Operations Group (SOG). As a Health Insurance Specialist, GS-0107-7/9, you will prepare and develop survey and certification policies, procedures and compliance oversight for healthcare providers and compliance oversight for healthcare providers and suppliers.

Duties

Examine and provide suggestions for modifications to existing operating policy and procedures relating to the survey and certification program. Conduct analytical studies and evaluate the effectiveness of program initiatives by gathering, organizing, and interpreting data. Make recommendations supported by facts and background. Assist in overseeing the enforcement of regulatory requirements for health, safety and quality of healthcare facilities. Respond to routine inquiries regarding program related activities to a variety of internal and external stakeholders. Complete administrative duties as needed to ensure the smooth operation of the organization. Develop short-term or long-range project plan to ensure logistics are handled efficiently, identifying potential bottlenecks, and resolving issues within the scope of authority.

Qualifications and evaluation

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 may 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 Flexibility Integrity/Honesty Interpersonal Skills Reading Comprehension 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.

How to apply

Please read the entire announcement and all the instructions before you begin an application. To apply and be considered for this position, you must complete all required questionnaires, assessments and submit all required documentation as specified in the How to Apply and Required Documents sections. The complete application package must be submitted by 11:59 PM (ET) on 09/11/2026. The application process is as follows: Click the Apply button. Answer the questions presented in the application and attach all necessary supporting documentation. Click the Submit Application button prior to 11:59 PM (ET) on 09/11/2026. If you are required to complete any USA Hire Assessments, you will be notified after submitting your application. The notification will be provided in your application submission screen and via email. The notification will include your unique assessment access link to the USA Hire system and the completion deadline. Additionally, in USAJOBS you can click "Track this application" to return to your assessment completion notice. Access USA Hire using your unique assessment link. Access is granted through your USAJOBS login credentials. Review all instructions prior to beginning your assessments. You will have the opportunity to request a testing accommodation before beginning the assessments should you have a disability covered under the Rehabilitation Act of 1973 as amended. Set aside at least 3 hours to take the USA Hire Assessments; however, most applicants complete the assessments in less time. If you need to stop the assessments and continue later, you can re-use your unique assessment link. Your responses to the USA Hire Assessments will be reused for one year (in most cases) from the date you complete an assessment. If future applications you submit require completion of the same assessments, your responses will be automatically reused. You may update your application documents and some questions related to your personal information at any time during the announcement open period. Upon application, you may be provided a testing window to complete additional assessments. This testing window may stipulate a completion deadline before the announcement closes. It is your responsibility to complete the additional online assessments within the timeline provided to remain in consideration for this vacancy announcement. Failure to complete the online assessments within the testing window for this announcement will not preclude you from being considered for and completing the online assessments during a testing window on a future announcement. Visit the USA Hire Applicant Resource Center for practice assessments and assessment preparation resources at https://support-usahire.opm.gov/hc/en-us. To update your application, including supporting documentation: During the announcement open period, return to your USAJOBS account, find your application record, and click Edit my application. This option will no longer be available once the announcement has closed. To view the announcement status or your application status: Visit https://help.usajobs.gov/how-to/application/status. Your application status page is where you can view your application status, USA Hire assessment completion status, and review your notifications sent by the hiring agency regarding your application. Commissioned Corps Officers (including Commissioned Corps professionally boarded applicants) who are interested in applying to this position must send their 1-page cover letter and 2-page ONLY professional resume (not PHS Curriculum Vitae) to CMSCorpsJobs@cms.hhs.gov in lieu of applying through this announcement. The resume should specifically explain how you are qualified for this position and draw specific attention to your skills and experiences that demonstrate these qualifications. Also, send any transcripts, licenses, or certifications as requested in this announcement. Please send all documents in 1 PDF file. In the subject line of your e-mail, include only the Job Announcement Number. In the body of your e-mail, include your current rank name and serial number. Failure to provide this information may impact your consideration for this position. Additional selections may be made for similar positions across the Department of Health and Human Services (HHS) within the local commuting area(s) of the location identified in this announcement. By applying, you agree to have your application shared with interested selecting official(s) at HHS. Clearance of CTAP/ICTAP will be applied for similar positions across HHS.

Required documents

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). For resume and application tips, visit: https://www.cms.gov/files/document/2026-required-documents.pdf Your resume will be used to validate your responses to the assessment tool(s). We strongly encourage applicants to utilize the USAJOBS resume builder in the creation of resumes. Determining length of general or specialized experience is dependent on the information provided in the resume. Failure to include ALL of the information listed below on your resume WILL result in a finding of ineligible. Official Position Title (include series and grade if Federal job) Duties (be specific in describing your duties) Employer's name and address Supervisor name and phone number Start and end dates in the month-year format (e.g., June 2007 to April 2008) Full-time or part-time status (include hours worked per week) Salary 2. CMS Required Documents (e.g., SF-50, DD-214, SF-15, etc.). Required documents may be necessary to be considered for this vacancy announcement. Failure to provide the required documentation WILL result in an ineligible rating OR non-consideration. 3. College Transcripts. 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. 4. 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. 5. RPL/PRL Eligibility Required Documents: If claiming RPL/PRL eligibility, the following documents are required to verify your RPL/PRL eligibility:1) Your most recent SF-50 (Notification of Personnel Action), or equivalent, as stated in the job announcement that shows position occupied (block #34 of your SF-50), tenure, grade and step, salary, and full performance level; 2) Your SF-50 showing Separation - RIF. If that is not available, official documentation of your Reduction in Force (RIF) separation notice or a proposed removal/separation notice; AND 3) Your latest performance rating and rating of record (if separate documents) showing your rating score as at least fully successful or equivalent.

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 Salary Ranges: Atlanta: $53,361 to $84,857 Boston: $57,150 to $90,882 Kansas City: $51,283 to $81,553 Seattle: $56,715 to $90,190 Woodlawn: $57,736 to $91,815 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.