Summary

This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicaid and CHIP Services (CMCS), Managed Care Group (MCG).

As a Health Insurance Specialist, GS-0107-13, you will serve as an expert in the development, evaluation, and implementation of policies related to Medicaid Managed Care Policy and/or other policy areas of responsibility that are located within the division.

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.

Clarification from the agency

This announcement is advertised under Direct Hire Authority and is open to all United States Citizens or Nationals.

Duties

Identify and develop changes to Medicaid Managed Care programs and Policy or other policy areas of responsibility that are located within the division, to ensure efficiency and effectiveness of program operations.
Evaluate the effectiveness of existing policies and review new policy and legislative initiatives for potential impact on Medicaid programs.
Analyze internal policies, processes, and procedures to assure increased efficiency in operations and implements policies, procedures, and processes to resolve problems and improve internal operations.
Work as a team member or ad hoc team leader on projects designed to develop, evaluate and implement Medicaid Managed Care programs and policy or other policy areas of responsibility that are located within the division.
Prepare a variety of written products, including briefing documents, contractor performance evaluations, reports, and issue papers.

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.
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 receiving further consideration.

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. Analyzing, developing, and implementing statute and regulations related to Managed Care program and similar national healthcare programs; AND
2. Providing technical assistance to states and stakeholders on Medicaid programmatic issues to ensure program compliance; AND
3. Developing briefing papers and technical documents (i.e. health policy statements, guidelines, decision papers) for leadership briefing and decision-making.

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.

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.

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.

Atlanta, GA: $112,556- $ 146,325
Dallas, TX: $115,711 - $150,426
Denver, CO: $118,675 - $ 154,280
Philadelphia, PA: $117,284 - $152,471
Woodlawn, MD: $121,785 - $158,322

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.

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.

Traditional rating and ranking of applications does not apply to this vacancy. Applications will be evaluated against the basic qualifications. Qualified candidates will be referred for consideration in accordance with the Office of Personnel Management direct hire guidelines. Veterans' Preference does not apply to direct hire recruitment procedures. 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.

You will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics):
Accountability, Customer Service, Decisiveness, Flexibility, Interpersonal Skills, Problem Solving, and Resilience.

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.

RPL Applicants
RPL applicants who are verified as registered for the same series, grade, and location as this vacancy announcement will be placed in one of the following categories based on category rating procedures:

Best Qualified - significantly exceeds the evaluation criteria
Well Qualified - excelsin the evaluation criteria
Qualified - meets 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.

The category rating process does not add veterans' preference points 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

The following documents are REQUIRED:

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 12/31/59. 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:
https://www.cms.gov/files/document/2026-required-documents.pdf

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.

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.

PLEASE NOTE: A complete application package includes the online application, resume, transcripts, 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, transcripts, and CMS required documents will result in your not being considered for employment.

If you are relying on your education to meet qualification requirements:

Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education.

Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.

How to Apply

Your complete application package, as described in the "Required Documents" section, must be received by 11:59 PM ET on 06/01/2026 to receive consideration.

IN DESCRIBING YOUR WORK EXPERIENCE AND/OR EDUCATION, PLEASE BE CLEAR AND SPECIFIC REGARDING YOUR EXPERIENCE OR EDUCATION.

We strongly encourage applicants to utilize the USAJOBS resume builder in the creation of resumes. Please ensure EACH work history includes ALL of the following information:

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 including month and year (e.g. June 2007 to April 2008)
Full-time or part-time status (include hours worked per week)

Determining length of general or specialized experience is dependent on the above information and failure to provide ALL of this information WILL result in a finding of ineligible.

To begin, click Apply to access the online application. You will need to be logged into your USAJOBS account to apply. If you do not have a USAJOBS account, you will need to create one before beginning the application.
Follow the prompts to select your resume and/or other supporting documents to be included with your application package. You will have the opportunity to upload additional documents to include in your application before it is submitted. Your uploaded documents may take several hours to clear the virus scan process.
After acknowledging you have reviewed your application package, complete the Include Personal Information section as you deem appropriate and click to continue with the application process.
You will be taken to the online application which you must complete in order to apply for the position. Complete the online application, verify the required documentation is included with your application package, and submit the application.

To verify the status of your application, log into your USAJOBS account (https://my.usajobs.gov/Account/Login), all of your applications will appear on the Welcome screen. The Application Status will appear along with the date your application was last updated. For information on what each Application Status means, visit: https://www.usajobs.gov/Help/how-to/application/status/.

This agency provides reasonable accommodation to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please send an email to hrinquiries@cms.hhs.gov. The decision to grant reasonable accommodation will be made on a case-by-case basis.

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.

Agency contact information

CMS HR Inquiries

Email: hrinquiries@cms.hhs.gov

Address: Center for Medicaid and CHIP Services
7500 Security Blvd
Woodlawn, MD 21244
US

Next steps

Once your online application is submitted, you will receive a confirmation notification by email. Within 30 business days of the closing date,06/01/2026, 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.

Additional locations

Dallas, TX

Health Insurance Specialist Job