Nurse US Centers for Medicare & Medicaid Services - 4.0 Woodlawn, MD Job Details Part-time | Full-time $85,447 - $133,142 a year 22 hours ago Qualifications Health policy analysis Nursing Medical claims processing Medicare Clinical program policy development RN License Claims payment authorization Health insurance policy knowledge Policy & process development Centers for Medicare & Medicaid Services (CMS) billing regulations Healthcare policy implementation Cross-functional collaboration Policy Development Nursing Full Job Description Summary 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. Learn more about this agency This job is open to The public U.S. Citizens, Nationals or those who owe allegiance to the U.S. Career transition (CTAP, ICTAP, RPL) Federal employees whose job, agency or department was eliminated and are eligible for priority over other applicants. Clarification from the agency This announcement is advertised under Direct Hire Authority and is open to all United States Citizens or Nationals. 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. Requirements Conditions of employment You must be a U.S. Citizen or National to apply for this position. You will be subject to a background and suitability investigation. Time-in-Grade restrictions apply.

Selective Service:

Males born after December 31, 1959, must be registered or exempt from Selective Service - http://www.sss.gov One-year probationary period may be required. 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. All Federal employees are required to have Federal salary payments made by direct deposit to a financial institution of their choice. The incumbent must have passed the National Council Licensure Examination (NCLEX). The incumbent must possess a current, active, full, and unrestricted license or registration as a professional nurse (i.e., RN) from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States. Qualifications

ALL QUALIFICATION REQUIREMENTS MUST BE MET BY THE CLOSING DATE OF THIS ANNOUNCEMENT.

Your resume (limited to no more than 2 pages) must include detailed information as it relates to the responsibilities and specialized experience for this position. Evidence of copying and pasting directly from the vacancy announcement without clearly documenting supplemental information to describe your experience will result in an ineligible rating. This will prevent you from receiving further consideration. Applicants must demonstrate that they meet the Basic Requirements as noted below.

Education:

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. In order to qualify for the GS-11, you must meet the following: You must demonstrate in your resume at least one year (52 weeks) of qualifying specialized experience equivalent to the GS-09 grade level in the Federal government, obtained in either the private or public sector, to include: 1.Assisting in identifying program vulnerabilities and proposing changes in procedures regarding clinical, policy, or operational issues. 2.Supporting the creation of clinical policies aimed at preventing or minimizing improper payments for services or items provided to Medicare beneficiaries. AND 3.Contributing to discussions on management program policy developments. - OR - Substitution of Education for

Experience:

You may substitute education for specialized experience at the GS-11 level by possessing a Ph.D. or equivalent doctoral degree or 3 full years of progressively higher-level graduate education leading to such a degree or equivalent doctoral degree or LL.M., if related to the position being filled. - OR -

Combination of Experience and Education:

Only graduate education in excess of the amount required for the GS-09 grade level may be used to qualify applicants for positions at grades GS-11. Therefore, only education in excess of a master's or equivalent graduate degree or 2 full years of progressively higher-level graduate education leading to such a degree may be used to combine education and experience.

TRANSCRIPTS

are required to verify satisfactory completion of the educational requirement related to the substitution of education for experience and the combination of experience and education. Please refer to the "Required Documents" section below for the documentation required at the time of application. In order to qualify for the GS-12 , you must meet the following: You must demonstrate in your resume at least one year (52 weeks) of qualifying specialized experience equivalent to the GS-11 grade level in the Federal government, obtained in either the private or public sector, to include: 1.Producing clinically informed recommendations to senior policy analysts related to assigned program integrity programs. 2.Supporting cross-organizational teams on projects and initiatives that impact program integrity operations. 3.Evaluating claims payments necessary to administer national health insurance programs. AND 4.Developing responses to inquiries regarding program integrity to a variety of internal and external stakeholders.

Time-in-Grade:

To be eligible, current or former Federal employees and current or former Federal employees applying under the VEOA eligibility who hold or have held a permanent General Schedule position in the previous year must have served at least 52 weeks (one year) at the next lower grade level from the position/grade level(s) to which they are applying. 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.

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 Additional information

Bargaining Unit Position:

Yes - American Federation of Government Employees, Local 1923

Tour of Duty:

Flexible Recruitment Incentive:

Not Authorized Relocation Incentive:

Not Authorized Financial Disclosure:

Not Required Workplace Flexibility at

CMS:

This position has a regular and recurring reporting requirement to the CMS office listed in this announcement. CMS offers flexible working arrangements and allows employees the opportunity to participate in alternative work schedules at the manager's discretion. The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced federal employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit the required documentation and be rated well-qualified for this vacancy. Click here for a detailed description of the required supporting documents. A well-qualified applicant is one whose knowledge, skills and abilities clearly exceed the minimum qualification requirements of the position. Additional information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website at www.opm.gov/rif/employee_guides/career_transition.asp. Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution. Benefits A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits. Review our benefits Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered. How you will be evaluated You will be evaluated for this job based on how well you meet the qualifications above. Traditional rating and ranking of applications does not apply to this vacancy. Applications will be evaluated against the basic qualifications. Qualified candidates will be referred for consideration in accordance with the Office of Personnel Management direct hire guidelines. Veterans' Preference does not apply to direct hire recruitment procedures. Selections made under this vacancy announcement will be processed as new appointments to the civil service. Current civil service employees would, therefore, be given new appointments to the civil service; however, benefits, time served and all other Federal entitlements would remain the same. Required Documents The following documents are

REQUIRED

1. Resume showing relevant experience; cover letter optional .

NOTE:

As of September 27, 2025, federal agencies will only accept resumes that are two pages or less in length. Your resume must indicate your citizenship and whether you are registered with the Selective Service if you are a male born after 12/31/59. Your resume must also list your work experience and education (if applicable), including the start and end dates (mm/yyyy) of each employment, along with the number of hours worked per week. For work in the Federal service, you must include the series and grade level for the position(s). Your resume will be used to validate your responses to the assessment tool(s). For resume and application tips, visit: https://www.cms.gov/files/document/2026-required-documents.pdf 2. CMS Required Documents (e.g., SF-50, DD-214, SF-15, etc.). Required documents may be necessary to be considered for this vacancy announcement. Failure to provide the required documentation WILL result in an ineligible rating OR non-consideration. 3. College Transcripts. Since this position requires specific education, you must submit a transcript attesting to your possession of the required education. You may submit an unofficial transcript or a list of college courses completed, indicating course titles, credit hours, and grades received. An official transcript is required if you are selected for the position. If selected, you must provide an original document before the final job offer may be extended. If you do not submit a transcript indicating your possession of the required education, you will not be considered for this position.

College Transcripts and Foreign Education:

Applicants who have completed part or all of their education outside the U.S. must have their foreign education evaluated by an accredited organization to ensure that it is comparable to the education received in accredited educational institutions in the U.S. For a listing of services that can perform this evaluation, visit the National Association of Credential Evaluation Services website. This list, which may not be all-inclusive, is for informational purposes only and does not imply any endorsement of any specific agency. If you are applying for a position for which a state license is issued (e.g., physician, engineer, attorney), possession of a valid and current U.S. professional license by a graduate of a foreign professional school or program is sufficient proof that the foreign education has been determined to be equivalent to the requisite U.S. professional education in that occupational field.

PLEASE NOTE

A complete application package includes the online application, resume, transcripts, and CMS required documents. Please carefully review the full job announcement, which includes the "Required Documents" and "How to Apply" sections. Failure to submit the online application, resume, transcripts, and CMS required documents will result in your not being considered for employment. If you are relying on your education to meet qualification requirements: Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education. Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating. How to Apply Your complete application package, as described in the "Required Documents" section, must be received by 11:59 PM ET on 09/15/2026 to receive consideration.

IN DESCRIBING YOUR WORK EXPERIENCE AND/OR EDUCATION, PLEASE BE CLEAR AND SPECIFIC REGARDING YOUR EXPERIENCE OR EDUCATION.

We strongly encourage applicants to utilize the USAJOBS resume builder in the creation of resumes. Official Position Title (include series and grade if Federal job) Duties (be specific in describing your duties) Employer's name and address Supervisor name and phone number Start and end dates including month and year (e.g. June 2007 to April 2008) Full-time or part-time status (include hours worked per week) Determining length of general or specialized experience is dependent on the above information and failure to provide ALL of this information WILL result in a finding of ineligible. To begin, click Apply to access the online application. You will need to be logged into your USAJOBS account to apply. If you do not have a USAJOBS account, you will need to create one before beginning the application. Follow the prompts to select your resume and/or other supporting documents to be included with your application package. You will have the opportunity to upload additional documents to include in your application before it is submitted. Your uploaded documents may take several hours to clear the virus scan process. After acknowledging you have reviewed your application package, complete the Include Personal Information section as you deem appropriate and click to continue with the application process . You will be taken to the online application which you must complete in order to apply for the position. Complete the online application, verify the required documentation is included with your application package, and submit the application. To verify the status of your application, log into your USAJOBS account (https://login.usajobs.gov/Account/), all of your applications will appear on the Welcome screen. The Application Status will appear along with the date your application was last updated. For information on what each Application Status means, visit: https://help.usajobs.gov/how-to/application/status. This agency provides reasonable accommodation to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please send an email to . The decision to grant reasonable accommodation will be made on a case-by-case basis. Commissioned Corps Officers (including Commissioned Corps professionally boarded applicants) who are interested in applying to this position must send their 1-page cover letter and 2-page ONLY professional resume (not PHS Curriculum Vitae) to in lieu of applying through this announcement. The resume should specifically explain how you are qualified for this position and draw specific attention to your skills and experiences that demonstrate these qualifications. Also, send any transcripts, licenses, or certifications as requested in this announcement. Please send all documents in 1 PDF file . In the subject line of your e-mail, include only the Job Announcement Number. In the body of your e-mail, include your current rank name and serial number. Failure to provide this information may impact your consideration for this position. Additional selections may be made for similar positions across the Department of Health and Human Services (HHS) within the local commuting area(s) of the location identified in this announcement. By applying, you agree to have your application shared with interested selecting official(s) at HHS. Clearance of

CTAP/ICTAP

will be applied for similar positions across HHS. Agency contact information CMS HR Inquiries Email Address Center for Program Integrity 7500 Security Blvd Woodlawn, MD 21244 US Next steps Once your online application is submitted, you will receive a confirmation notification by email. Within 30 business days of the closing date, 09/15/2026, you may check your status online by logging into your USAJOBS account (https://login.usajobs.gov/Account/). We will update your status after each key stage in the application process has been completed. Overview Accepting applications Location 3 vacancies in the following location: Woodlawn, MD No matching locations found. Work site options Telework eligible Yes—as determined by the agency policy. Remote job No Relocation expenses reimbursed No Salary $85,447 - $133,142 per year Pay scale & grade

GS 11 - 12

Promotion potential 12 Learn more about pay scale and grade Pay scale and grade determines the salary of the job. Work schedule Full-time Travel Required 25% or less - You may be expected to travel for this position. Appointment type Permanent Occupations and job series 0610 Nurse Supervisory status No Federal service type This job is in the Competitive Service Represented by a union Yes Drug test No Security clearance Not Required Position sensitivity and risk Moderate Risk (MR) Jobs require a background check and some require a security clearance. The type depends on the job. Background check type Credentialing Suitability/Fitness Financial disclosure required No Some jobs require financial disclosure to identify conflicts of interests. Announcement number

CMS-CPI-26-13053370-DH

Control number 883889700