Department of Health and Human Services

Health Insurance Specialist (Data Analysis and Studies)

Atlanta, Georgia, Boston, Massachusetts, Woodlawn, Maryland, Philadelphia, Pennsylvania, Dallas, Tex Full time

Health Insurance Specialist (Data Analysis and Studies)

Department: Department of Health and Human Services

Location(s): Atlanta, Georgia, Boston, Massachusetts, Woodlawn, Maryland, Philadelphia, Pennsylvania, Dallas, Texas

Salary Range: $90925 - $118204 Per Year

Job Summary: This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS). As a Health Insurance Specialist (Data Analysis and Studies), GS-0107-13, you will conduct program related studies regarding quality of care, program oversight, utilization of program services by the beneficiaries, and analysis of policy issues, etc.

Major Duties:

  • Apply evaluative skills and determine future organizational impact on current operations.
  • Ensure research and analysis conducted are technically sound and conform to policies, directives, and studies.
  • Develop new techniques to research and prepare raw health insurance program data more efficiently and effectively within the Group/Division.
  • Review the legal background, legislative history, administrative case law, and court decisions that interpret the policies and regulations for the CMS programs.
  • Develop and implement programs and techniques to improve data quality and business practices for the Group/Division.

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) Designing, planning, and conducting quantitative data studies to evaluate the impact on health insurance programs healthcare trends that impact CMS programs; AND (2) Using qualitative and quantitative techniques to identify trends, root causes, contributing factors, or recommendations related to health insurance programs or healthcare administration; AND (3) Identifying potential policy and operational problem areas and then devising and implementing solutions; AND (4) Preparing briefings or summary reports to explain data obtained from studies. 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/12857160

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 01/06/2026. 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 01/06/2026. 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 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. 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.

Application Deadline: 2026-01-06