KEY REQUIREMENTS



• You must be a U.S. Citizen or National to apply for this position.
• You must meet the Selective Service requirements (See “Other Information”).
• You must complete the questionnaire and/or knowledge, skills and abilities.
• A one-year probationary period MAY be required.
• Use the Print Preview feature for a complete copy of this announcement.

In this position you will serve as a Nurse Consultant responsible for providing clinical and professional advice, guidance, and oversight to Medicare contractors in their performance of medical review and utilization review activities for Medicare Skilled Nursing Facilities, Home Health Agencies, hospitals, and other providers.   Specifically, you will:

Provide clinical expertise in the review and evaluation of Medicare contractors medical review and utilization review claims adjudication.

Perform ongoing monitoring of Medicare contractors and conduct onsite visits to review medical records.

Ensure the Medicare contractor’s perform the reviews of claims in accordance with Federal guidelines.

Work with Medicare contractors to implement new and improved medical review and utilization review procedures and screens.

Analyze program performance data and identify trends and  problem areas.

Conduct and participate in special studies.

A determination of your minimum qualifications will be based on the requirements listed below.  You will be evaluated based upon the experience and/or education reflected in your resume.  Please use clear and concise descriptions/examples when describing your experience.  Applicants are advised that all information concerning qualifications is subject to investigation.  By submitting your application, you are certifying the accuracy of the information contained in your application.  If you make a false statement in any part of your application, you may not be hired; you may be terminated after you begin work; or, you may be fined or jailed. ALL QUALIFICATION REQUIREMENTS MUST BE MET WITHIN 30 DAYS FROM THE CLOSING DATE OF THIS ANNOUNCEMENT.

BASIC QUALIFICATIONS:  Each applicant must possess the following:
 
Registration: Applicants must have active, current registration as a professional nurse in a State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States. An applicant who has graduated from an approved nursing educational program within the past 12 months may be appointed pending State registration as a professional nurse within 6 months of appointment. No person appointed pending registration may be retained beyond 6 months, or promoted, if registration has not been attained.
 
MINIMUM QUALIFICATIONS:  In addition to meeting the Basic Qualifications listed above, each applicant MUST also meet the following specialized experience requirement.
 

Specialized Experience: Specialized Experience is experience that has equipped the applicant with the particular knowledge, skills, and abilities to perform successfully the duties of the position and is typically in or related to the work of the position to be filled.

Specialized experience is defined as one (1) year (52 weeks) of specialized experience (equivalent to the grade 11 level in the Federal service) which includes:Interpreting and providing clinical assistance and written direction regarding medical review and utilization review regulations, policies, and procedures to Medicare beneficiaries, physicians, providers, congressional staff, and Medicare contractors; performing medical review audit activities for skilled nursing facilities, home health agencies, hospitals and other providers; assessing contractor performance in executing the terms of their contract; and gathering, evaluating, and analyzing information for use in drawing conclusions and devising solutions.  

Substitution of Education for Experience: There is no substitution of education for specialized experience at this grade level.

Combination of Experience and Education: There is no combination of experience and education for this grade level.

You must submit a copy of your license and your transcripts in order to receive consideration.

Degree or diploma from a professional nursing program approved by the legally designated State accrediting agency at the time the program was completed by the applicant. (One year of nursing experience as a military corpsman that has been accepted by a State licensing body may be accepted in lieu of education at the GS-4 level.)

Foreign Education: If you are using education completed in foreign colleges or universities to meet the qualification requirements, additional supporting documentation is required. Click here for more information about REQUIRED DOCUMENTS.

Conditions of Employment:

1. Security and Background Requirements: If not previously completed, a background security investigation will be required for all appointees. Appointment will be subject to the applicant's successful completion of a background security investigation and favorable adjudication. Failure to successfully meet these requirements may be grounds for appropriate personnel action. In addition, if hired, a background security reinvestigation or supplemental investigation may be required at a later time. Applicants are also advised that all information concerning qualifications is subject to investigation. False representation may be grounds for non-consideration, non-selection and/or appropriate disciplinary action.

·    Optional Form 306 – Declaration of Federal Employment – available at http://www.opm.gov/forms/pdf_fill/of306.pdf. This form is not required to be submitted at the time of submitting your application. However, if selected, this form will be required prior to final job offer.

2. E-Verify: If you are selected for this position, the documentation that you present for purposes of completing the Department of Homeland Security (DHS) Form I-9 will be verified through the DHS "E-Verify" System. Federal law requires DHS to use the E-Verify System to verify employment eligibility of all new hires, and as a condition of continued employment obligates the new hire to take affirmative steps to resolve any discrepancies identified by the system. The U.S. Department of Health and Human Services is an E-Verify Participant.

3. Direct Deposit: All Federal employees are required to have Federal salary payments made by direct deposit to a financial institution of their choosing.

HOW YOU WILL BE EVALUATED:

Once the application process is complete, a review of resume and supporting documentation will be made and compared against your responses to the assessment questionnaire to determine if you are qualified for this job.  If, after reviewing your resume and or supporting documentation, a determination is made that you have inflated your qualifications and or experience, you may lose consideration for this position.  Please follow all instructions carefully. Errors or omissions may affect your eligibility.  Category rating procedures will be used to rate and rank candidates. The category assignment is a measure of the degree in which your background matches the competencies required for this position. Qualified candidates will be ranked into one of three categories: Best Qualified, Well Qualified or Qualified.

The Category Rating Process does not add veterans’ preference points but protects the rights of veterans by placing them ahead of non-preference eligibles within each category. Preference eligibles who meet the minimum qualification requirements and who have a compensable service-connected disability of at least 10 percent must be listed in the highest quality category (except in the case of scientific or professional positions at the GS-9 level or higher).

Your qualifications will be evaluated on the following competencies (knowledge, skills, abilities and other characteristics):

Technical Knowledge

Program Management

Written Communications

Oral Communications

Your résumé and/or supporting documentation will be verified.   Please follow all instructions carefully. Errors or omissions may affect your rating or consideration for employment.

NOTE: If you submit a resume but no questionnaire, you will not be considered for the position. If you submit a questionnaire but no resume, you cannot be considered for the position. Your application will be appropriately documented and you will be removed from competition.

The Federal government offers a number of exceptional benefits to its employees. The following Web addresses are provided for your reference to explore the major benefits offered to most Federal employees: http://www.usajobs.gov/ResourceCenter/Index/Interactive/Benefits#icc

Flexible Spending Accounts -  https://www.fsafeds.com/fsafeds/index.asp

Health Insurance - http://www.opm.gov/insure/health/index.asp 

Leave -  http://www.opm.gov/oca/leavel/index.asp
Life Insurance -   http://www.opm.gov/insure/life/index.asp
Long Term Care Insurance - http://www.ltcfeds.com/

Retirement Program -   http://www.opm.gov/retire/index.asp

OTHER INFORMATION:

WORK SCHEDULE: Full Time

TRAVEL REQUIREMENT: Yes

TOUR OF DUTY: Flexible

FAIR LABOR STANDARDS ACT: Exempt 

RELOCATION EXPENSES (PCS): Not Authorized

RECRUITMENT INCENTIVE:  No

SECURITY REQUIREMENTS: NACI

FINANCIAL DISCLOSURE: No

BARGAINING UNIT POSITION:  Yes                                

JOB CODE:  H_8600

TRANSCRIPTS or COURSE LISTINGS: No

NOTE:  An unofficial transcript or a list of courses, grades earned, completion dates, and quarter and semester hours earned can be used as a substitute for the official transcript at the time the person applies for a job opening.

DISPLACED FEDERAL EMPLOYEES: If you are a displaced Federal Employee, you may be eligible for priority consideration under the Interagency Career Transition Assistance Plan (ICTAP). Please visit this link to obtain requirements for applying as an ICTAP eligible applicant    http://www.opm.gov/rif/employee_guides/career_transition.asp#ictap. If you feel as though you are elibible under the ICTAP program, please see the "REQUIRED DOCUMENTS" sections below. Candidates must meet or exceed the Well Qualified category to be considered for this vacancy as an ICTAP eligible.

VETERANS' PREFERENCE: If you are a veteran with preference eligibility and you are claiming 5-points veterans' preference, you must submit a copy of your DD-214 or other proof of eligibility. If you are claiming 10-point veterans' preference, you must also submit an SF-15, "Application for 10-Point Veterans' Preference" plus the proof required by that form. Documentation intended to establish preference must be received by 11:59PM EST on the closing date of this announcement. Information on veterans' preference and other veteran entitlements can be found in the VetInfo Guide:  http://www.opm.gov/staffingportal/vetguide.asp

JOB SEEKERS WITH DISABILITIES: Federal agencies fill jobs two ways, competitively and non-competitively. Persons with disabilities may apply for jobs filled either way. People who are selected for jobs must meet the qualification requirements and any education requirements for the jobs and be able to perform the essential duties of the jobs with or without reasonable accommodation. For information, please visit http://opm.gov/disability/PeopleWithDisabilities.asp

To begin the process, click the Apply Online button to create an account or log in to your existing USAJOBS account.  Follow the prompts to complete the assessment questionnaire.  Please ensure you click the Submit My Answers button at the end of the process.

Note: To return to a previously Saved or Incomplete application you may use the following link: https://applicationmanager.gov/ .

To fax supporting documents you are unable to upload, complete this cover page http://staffing.opm.gov/pdf/usascover.pdf using the following vacancy 741725.  Fax your documents to 1-478-757-3144.

If you cannot apply online:

1. Click the following link to view and print the assessment questionnaire View Occupational Questionnaire; and  

2. Print this 1203FX form to provide your response to the assessment questionnaire http://www.opm.gov/forms/pdf_fill/OPM1203fx.pdf; and 

3. Fax the completed 1203FX form along with any supporting documents to 1-478-757-3144.  Your 1203FX will serve as a cover page for your fax transmission.

4. This agency provides reasonable accommodation to applicants with disabilities.  If you need a reasonable accommodation for any part of the application and hiring process, please contact the CMS HelpDesk at 1( 888)423-2737 or (410)786-3936 TTY/TDD: (410)786-0270; or by email HRCenterHelpdesk@cms.hhs.gov. The decision on granting reasonable accommodation will be made on a case-by-case basis.

NOTE: Submission of a résumé alone IS NOT a complete application. This position requires the completion of additional forms and/or supplemental materials as described under the "REQUIRED DOCUMENTS" section of this announcement. Please carefully review the complete job announcement and the "How to Apply" instructions. Failure to provide the required information and/or materials will result in you not being considered for employment. 

REQUIRED DOCUMENTS:

The following documents are required:
 
1.  Resume showing relevant experience; cover letter optional.  Your resume must indicate your citizenship and if you are registered for Selective Service if you are a male born after 12/31/59.  Your resume should also list your educational and work experience including the dates (mm/dd/yy) of each employment along with the number of hours worked per week.  For work in the Federal service, please include the grade level for the position(s).  Your resume may be used to validate your responses to the assessment tool(s). 
 
For Résumé and Application Tips visit:
http://www.usajobs.gov/ResourceCenter/Index/Interactive/ResumeAndApplicationTips#icc
 
2.  A complete Assessment Questionnaire
3.  Supplemental Documents, if applicable (i.e., SF-50, DD-214, SF-15 etc).
 
Supplemental documents may be required in the vacancy announcement.   Failure to provide appropriate documentation MAY result in a not qualified rating OR non-consideration. Click here for a detailed description of the REQUIRED DOCUMENTS. 
 
You will be required to submit official documentation prior to appointment.  The agency will then verify the information provided on your application (i.e., degree, veterans' preference, disability, etc.).

The complete Application Package (including all required documents) must be submitted by 11:59 PM (EST) on Wednesday, September 19, 2012.

Contact Information: CMS HR Center Helpdesk
Phone: 1-888-423-2737 or 410-786-3936
TDD: (410)786-0270
Email: HRCenterHelpdesk@cms.hhs.gov

Hours of Operation: Monday - Friday from 8:00AM ET to 5:00PM ET (excludes all Federal holidays) 

AGENCY CONTACT INFO:

WHAT TO EXPECT NEXT:

Once the online questionnaire is received you will receive an acknowledgement email that your submission was successful.  The most highly qualified candidates will be referred to the hiring manager for further consideration and possible interview.  We expect to make a selection within 45 days of the closing date of this announcement.

You will receive notice via email or by mail, if no email address was provided by you during the application process, once this process is completed (generally 4-6 weeks).