Program Analyst

Summary

As a Program Analyst at the GS-0343-12/13, you will be part of Healthcare and Insurance Office of Personnel Management. If selected, you will be responsible for negotiating benefits with carriers, administering and monitoring health benefit plan contracts, responding to customer request, and reviewing and resolving complaints.

Duties

Assist with preparations of regular monthly, quarterly, and annual disputed claims.Research and responds to problems or situations requiring the use of established methodologies to isolate and evaluate appropriate precedents.Identifies, processes, and organizes data from non-Federal Disputed Claim (FDC) System sources to inform and analyze Disputed Claims Team reporting and initiatives.Develops reports, evaluations, project timelines and results for the Disputed Claims supervisor.Examines and analyzes documentation and data to reconcile discrepancies or inconsistencies and to develop supportable conclusions based on research.

Requiremennts

Must be a U.S. Citizen or National Males born after 12-31-59 must be registered for Selective Service Suitable for Federal employment, determined by a background investigation May be required to successfully complete a probationary period Complete the initial online assessment and USAHire Assessment, if required This position is eligible for inclusion in the bargaining unit. if the duty station is finalized in the Washington, DC metropolitan area, employees in this position will be represented by the American Federation of Government Employees (AFGE) Local 32. (BU Code - 2286) if the duty station is finalized outside of the Washington, DC metropolitan area, this position will not be represented by a bargaining unit. (BU Code - 7777)

Qualifications

For the GS-12: You must have at least one year (52 weeks) of specialized experience which is equivalent in difficulty and complexity to the GS-12 grade level in the Federal service that demonstrates ALL of the following: 1. Providing support in negotiating benefits analyzing health or insurance information to present findings, conclusions or recommendations to management; 2. Interpreting health benefit contract provisions technical reports, internal guidance, or documentation to improve efficiency of operations; AND 3. Monitoring health benefit plan contracts insurance information to reconcile discrepancies and identify a solution based on research. For the GS-13: You must have at least one year (52 weeks) of specialized experience which is equivalent in difficulty and complexity to the GS-12 grade level in the Federal service that demonstrates ALL of the following: 1. Analyzing health or insurance information to present findings, conclusions or recommendations to management; 2. Developing technical reports, internal guidance, or documentation to improve efficiency or operations; AND 3. Examining health or insurance information to reconcile discrepancies and identify a solution based on research. Merit promotion applicants must meet time-in-grade requirement as defined in 5 CFR 300, Subpart F. One year at the GS-11 level is required to meet the time-in-grade requirements for the GS-12 level. One year at the GS-12 level is required to meet the time-in-grade requirements for the GS-13 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.

At OPM, we are champions of talent for the Federal Government. We lead Federal agencies in workforce policies, programs, and benefits in service to the American people. We will create a new vision of work, together, positioning the Federal Government as a model employer for past and present employees through innovation, inclusivity, and leadership. We will build a rewarding culture that empowers the workforce to solve some of our nation's toughest challenges. For information on OPM's goals and objectives, please refer to our Strategic Plan.