This position is within the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Program Integrity, Provider Compliance Group (PCG). As a Nurse, GS-0610-11/12, you will provide authoritative clinical and nursing advice and guidance as part of CMS program policy or support teams responsible for interpreting applicable laws, regulations, and policies for complex, controversial or sensitive issues in CMS-administered program.
Major duties: Conducts in-depth research on the background and origin of laws, regulations, and policies, and their intended impact on healthcare programs.,Works with various CMS components on data interpretation, recovery audits, claims processing and payment, medical review, and appeals to ensure consistent and accurate implementation of clinical Medicare policy.,Supports cross-functional and cross-organizational teams on projects and initiatives that impact program integrity operations.,Participates in and leads analytical studies to evaluate the effectiveness of policies by gathering, organizing, and interpreting clinical and program data.,Serves as a CMS point of contact for beneficiaries, providers, suppliers, professional associations, congressional offices, and contractors.
Education: Education Requirement: In addition to meeting the qualification requirements, all candidates must have the following educational requirements: A graduate or higher-level degree, bachelor's degree, associate degree, or diploma from an accredited professional nursing educational program is required. This education must have been accredited by the Commission on Collegiate Nursing Education, Council on Accreditation of Nurse Anesthesia Educational Programs, Accreditation Commission for Midwifery Education, or an accrediting body recognized by the U.S.
Department of Education at the time the degree was obtained; OR a Degree from Foreign Nursing School: Official certification from the Commission on Graduates of Foreign Nursing Schools is required for individuals who graduated from foreign nursing schools. Licensure: For all grade levels and positions, applicants must have passed the National Council Licensure Examination. In addition, they must possess a current, active, full, and unrestricted license or registration as a professional nurse from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.
Exemption: Employees currently assigned to positions in this occupational series as of September 2017 will be considered to have met the basic requirements for the position occupied. TRANSCRIPTS are required to verify satisfactory completion of the educational requirement listed above. Failure to submit a copy of your transcripts at the time of application WILL result in an ineligible rating. Please see "Required Documents" section below for what documentation is required at the time of application.
Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/13053370