Program Analyst

Analyzes health care provider misconduct cases to determine whether administrative sanctions statutes and regulations apply. Researches and develops case information from documentary, online, governmental, and private-sector sources to support administrative sanction actions.

Prepares decision memoranda applying laws and regulations to case facts and recommending suspensions, debarments, financial penalties, waivers, exceptions, or reinstatements. Evaluates health insurance carriers' implementation of sanctions, identifies noncompliance, and coordinates corrective action with appropriate officials.

Develops, maintains, and reconciles sanctions data on health care providers and health insurance carriers for program administration and reporting. Recommends policies, methods, procedures, and improvements for administering the sanctions program.

Provides information and guidance to health insurance carriers and health care providers regarding sanction orders and applicable due process procedures.

For the GS 13: You must have one year of specialized experience equivalent to at least the GS-12 level in the Federal service (or equivalent). You must include evidence of this specialized experience in your resume, including dates of experience (month/year), to be considered qualified for this position.

Specialized experience for this position must include ALL of the following: Analyzing cases involving alleged misconduct or noncompliance to determine the applicability of statutes, regulations, or policies; Evaluating information from documentary, electronic, governmental, or other sources to develop factual records supporting administrative actions; Preparing written analyses that apply governing requirements to case facts and provide recommendations for administrative action; AND Evaluating compliance with administrative or enforcement actions.

Merit promotion applicants must meet the time-in-grade requirement as defined in 5 CFR 300, Subpart F. One year at the GS-12 grade level is required to meet the time-in-grade requirements for the GS13 level. You must meet all qualification and eligibility requirements within 30 days of the closing date of this announcement.

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.