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Health Insurance Specialist

US Centers for Medicare & Medicaid Services -
Denver, CO

Apply Now

Job Details

Part-time | Full-time
$108,173 - $158,322 a year

Qualifications

Evaluation research
Compliance audits & assessments
Research data analysis
Process program evaluations

Full Job Description

Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS).

As a Health Insurance Specialist, GS-0107-13, you will develop, evaluate and implement compliance, audit and oversight requirements, policies, operating procedures related to activities and processes involved with the monitoring and oversight of external CMS stakeholders who contract or provide services in support of CMS' lines of business.

Learn more about this agency

This job is open to

The public

U.S. Citizens, Nationals or those who owe allegiance to the U.S.

Career transition (CTAP, ICTAP, RPL)

Federal employees whose job, agency or department was eliminated and are eligible for priority over other applicants.

Duties

Leads tasks designed to develop, evaluate, and implement Medicare, Medicaid and Children's Health Insurance Program (CHIP), Marketplace Exchange, and private health insurance programs.
Develops, implements, and maintains operational requirements, including standard operating procedures for oversight of entities that provide health care and prescription drug services.
Develops and reviews health care policies and legislation in order to draft related policy documents, regulations, procedures and guidance to states.
Conducts analytical studies and evaluates the effectiveness of program initiatives by gathering, organizing, and interpreting data.
Attends meetings and conferences with CMS staff and serve as a source of background data on the basis of research performed in preparation for the meetings and conferences.

Requirements

Conditions of employment

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.
Selective Service: Males born after December 31, 1959, must be registered or exempt from Selective Service - http://www.sss.gov
One-year probationary period may be required.
If you are selected for this position, the documentation that you present for purposes of completing the Department of Homeland Security (DHS) Form I-9 will be verified through the DHS "E-Verify" System.
All Federal employees are required to have Federal salary payments made by direct deposit to a financial institution of their choice.

Qualifications

ALL QUALIFICATION REQUIREMENTS MUST BE MET BY THE CLOSING DATE OF THIS ANNOUNCEMENT.

Your resume (limited to no more than 2 pages) 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 being considered further.

In order to qualify for the GS-13, 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-12 grade level in the Federal government, obtained in either the private or public sector, to include: (1) Developing oversight strategies of health care or prescription drug service providers; (2) Evaluating methods used to identify vulnerabilities in a national health insurance program; and (3) Analyzing research or data to propose improvements to a health insurance program..

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.

Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/13006139

Education

This job does not have an education qualification requirement.

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

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.

Salary Range
Atlanta, GA - $112,556 - $146,325
Boston, MA - $120,548 - $156,715
Dallas, TX - $115,711 - $150,426
Denver, CO - $118,675 - $154,280
Kansas City, MO - $108,173 - $140,627
Seattle, WA - $119,630 - $155,521
Woodlawn, MD - $121,785-$158,322

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.

Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.

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. Opens in a new windowLearn more about federal benefits.

Review our benefits

Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.

How you will be evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

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. 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
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.

You will be placed in one of the following categories based on category rating and selection procedures if you meet all of the requirements outlined in this job opportunity announcement:

Best Qualified - for those who are superior in the evaluation criteria
Well Qualified - for those who excel in the evaluation criteria
Qualified - for those who only meet the minimum qualification requirements

If you are found to be among the top-qualified candidates, you will be referred to the selecting official for employment consideration.

This is a competitive vacancy announcement advertised under Delegated Examining Authority. Selections made under this vacancy announcement will be processed as new appointments to the civil service. Current civil service employees would therefore be given new appointments to the civil service; however, benefits, time served, and all other Federal entitlements would remain the same.

The category rating process does not add veterans' preference points or apply the "rule of three" but protects the rights of veterans by placing them ahead of non-preference eligibles within each category. Veterans' preference eligibles who meet the minimum qualification requirements and who have a compensable service-connected disability of at least 10 percent will be listed in the highest quality category (except in the case of professional or scientific positions at the GS-09 level or higher).

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 and 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. 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.

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 08/14/2026. 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 08/14/2026.

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.

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 [email protected] 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.

When the Department of Health and Human Services (HHS) completes its selections, the remaining list of qualified candidates may be shared with other federal agencies. You will have an opportunity to opt in if you would like your name, application material, and assessment results shared for consideration of employment with additional agencies. There is no guarantee of further consideration, and you can continue to explore other job opportunity announcements.

Agency contact information

CMS HR Inquiries

[email protected]

Address

CMS Global Hiring
7500 Security Blvd
Woodlawn, MD 21244
US

Next steps

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, [Close Date Data Insert], you may check your status online by logging into your USAJOBS account (https://login.usajobs.gov/Account/). We will update your status after each key stage in the application process has been completed.

Overview

Accepting applications

Location

25 vacancies in the following locations:

Denver, CO

Atlanta, GA

Boston, MA

Woodlawn, MD

Kansas City, MO

Dallas, TX

Seattle, WA

No matching locations found.

Work site options

Telework eligible

Yes—as determined by the agency policy.

Remote job

Relocation expenses reimbursed

Salary

$108,173 - $158,322 per year

Please see "Additional Information" for locality pay rates.

Pay scale & grade

GS 13

Promotion potential

Learn more about pay scale and grade

Pay scale and grade determines the salary of the job.

Work schedule

Full-time

Travel Required

Occasional travel - You may be expected to travel for this position.

Appointment type

Permanent

Occupations and job series

0107 Health Insurance Administration

Supervisory status

Federal service type

This job is in the Competitive Service

Represented by a union

Yes

Drug test

Security clearance

Not Required

Position sensitivity and risk

Non-sensitive (NS)/Low Risk

Jobs require a background check and some require a security clearance. The type depends on the job.

Background check type

Credentialing
Suitability/Fitness

Financial disclosure required

Some jobs require financial disclosure to identify conflicts of interests.

Announcement number

CMS-GH-26-13006139-DE

Control number

876728900

Apply Now

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Summary

This job is open to

The public

Career transition (CTAP, ICTAP, RPL)

Duties

Requirements

Conditions of employment

Qualifications

Education

Additional information

Benefits

How you will be evaluated

Required Documents

How to Apply

Agency contact information

Next steps

Overview