What are the responsibilities and job description for the Health Insurance Specialist position at Centers for Medicare & Medicaid Services?
About the Company
Learn more about working at CMS. Visit our CMS LinkedIn Careers page to hear from leadership and explore our hiring priorities: https://www.linkedin.com/company/centers-for-medicare-&-medicaid-services/life/a8009813-3bf5-4d64-bd6f-ca176c2c0a97
About the Role
READY TO STRENGTHEN OVERSIGHT OF AMERICA'S HEALTH PROGRAMS? Join CMS as a Health Insurance Specialist developing the compliance, audit, and oversight requirements that keep healthcare programs accountable. At CMS, you'll shape policies and procedures for monitoring the contractors and providers who deliver services across Medicare, Medicaid, CHIP, and the Marketplace—protecting quality and integrity for 150 million Americans. Your oversight could safeguard healthcare for millions. Are you ready to get started?
Responsibilities
- Lead tasks to develop, evaluate, and implement Medicare, Medicaid, CHIP, Marketplace Exchange, and private health insurance programs
- Develop and maintain operational requirements, including standard operating procedures for oversight of entities providing health care and prescription drug services
- Develop and review health care policies and legislation to draft policy documents, regulations, procedures, and guidance to states
- Conduct analytical studies and evaluate program effectiveness by gathering, organizing, and interpreting data
- Serve as a source of background data for CMS meetings and conferences
Qualifications
- Experience developing oversight strategies for health care or prescription drug service providers
- Background evaluating methods to identify vulnerabilities in a national health insurance program
- Experience analyzing research or data to propose improvements to a health insurance program
Required Skills
- Position: GS-0107-13 (25 vacancies)
- Resume required (2 page limit). Apply through USAJOBS by August 14, 2026.
Pay range and compensation package
Salary: $108,173 - $158,322/year (varies by location)
Locations: Denver, CO | Atlanta, GA | Boston, MA | Woodlawn, MD | Kansas City, MO | Dallas, TX | Seattle, WA (Telework eligible)
Equal Opportunity Statement
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Salary : $108,173 - $158,322