Summary
This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Consumer Information and Insurance Oversight (CCIIO), Front Office. As a Health Insurance Specialist, GS-0107-14, you will serve as a Health Insurance Specialist and the Operations Lead responsible for designing, governing, and continuously improving the operational infrastructure that enables investigation, and remediation of fraud, waste, and abuse.
Duties
Design, establish, and continuously refine the Center’s operational infrastructure to identify, track, and remediate complex fraud, waste, and abuse within the Health Insurance Marketplace.
Develop risk-based operational strategies designed to strengthen program safeguards and mitigate fraud risks across the Marketplace program.
Direct Center-level governance of fraud, waste, and abuse operations, designing and maintaining the cross-group processes by which MPMG, MEEG, MITG, and PPFMG coordinate their respective roles.
Lead Center-level strategic planning initiatives designed to enhance the effectiveness, resilience, and long-term sustainability of fraud prevention, remediation, and enforcement operations supporting Marketplace program integrity.
Serve as the principal liaison and authoritative advisor to senior leadership on complex fraud, waste, and abuse issues affecting the Health Insurance Marketplace.
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.