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Health Insurance Specialist
Centers for Medicare & Medicaid Services · Posted 56 days ago
Hybrid District of Columbia, DC $144K – $187K Apply by Aug 20, 2026 Health Insurance Administration ENTJENTPINTJINTP EngineeringOperations
Apply for this job → About the Role
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.
What You'll Do
- →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.
Personality Fit
Job ID: 31df98d3-bed1-4cb6-9683-38da003e9485
Posted via USAJobs