Chief Medical Officer

If selected you will be responsible for:

• Staying abreast of new clinical guidelines preventive care recommendations treatments devices and procedures for possible incorporation or inclusion into HI programs.
• Identifying innovations in public and private-sector health delivery finance and payment models which could reduce healthcare costs and improve healthcare quality and patient outcomes.
• Highlighting best practices for incorporation into HI publications guidance and educational sessions. Collaborating closely with the Chief Pharmacy Officer on matters pertaining to prescription drug coverage and formulary structure. Contributes substantially to the development of OPMs annual Call Letter Carrier Technical Guidance Annual Reports and Automated Data Collection (preparation analysis and interpretation).
• Maintaining a rigorous evidence-based process to inform HI benefit designs and coverage determinations. This process identifies new treatments or procedures that transition from experimental or investigational to standard of care as well as periodically reviewing existing coverage parameters for currency.
• Consulting and assisting Federal Employee Health Benefits (FEHB) Postal Service Health Benefits (PSHB) and Federal Employee Dental and Vision Insurance Program (FEDVIP) contracting groups in ensuring that carrier benefit proposals are responsive to OPM requirements as needed.

Conditions of employment

• Must be a U.S. Citizen or National
• Subject to a 1-year supervisory probationary period (unless already completed).
• Complete a Declaration for Federal Employment to determine your suitability for Federal employment at the time requested by the agency
• If you are a male applicant born after December 31 1959 certify that you have registered with the Selective Service System or are exempt from having to do so.
• May be subject to pre-employment and random drug tests.
• File a Confidential Financial Disclosure Report OGE-278e within 30 days of appointment and annually from then on.
• You may be required to obtain and maintain an interim and/or final security clearance prior to entrance on duty. Failure to obtain and maintain the required level of clearance may result in the withdrawal of a job offer or removal.
• This is not a remote position selectee will be required to report to the duty station on a regular basis. Telework may be authorized.

• Noncriminal Justice Applicants Privacy Rights for those who undergo an FBI fingerprint-based criminal history record check for personnel vetting which includes Rap Back
• FD-258 Privacy Act Statement - FBI (this is the same statement used when your fingerprints are submitted as part of your background investigation) and
• () (applicable to those who hold a sensitive position or have eligibility for access to classified information)

Qualifications

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. Candidates will not be hired based on their race sex color religion or national origin.

All applicants must have 1 year of specialized experience. Specialized experience is directly related to the duties and responsibilities of this position referenced in the technical qualifications that equipped the candidate with the scope and level of knowledge skills and abilities to successfully perform the work. Eligibility will be based upon a clear showing that the applicant has had professional training and experience of the scope level and quality sufficient to carry out the responsibilities of the position effectively.

To meet the minimum qualification requirements for this position you must show that you possess the Senior Professional Qualifications (SPQs) and Mandatory Technical Qualifications (MTQs) related to this position within your resume - NOT TO EXCEED 2 PAGES. Resumes over the 2-page limit will not be reviewed beyond page 2 or may be disqualified.

Your resume should include examples of experience education and accomplishments applicable to the qualification(s). If your resume does not reflect demonstrated evidence of these qualifications you may not receive consideration for the position.

MANDATORY TECHNICAL QUALIFICATIONS (MTQs): Your resume should demonstrate accomplishments that would satisfy the mandatory technical qualifications.

• Clinical knowledge and experience/expertise in medical leadership within the health policy/health management sphere. Possesses both medical knowledge and an understanding of healthcare benefits management and delivery systems.
• Board certified or Board-eligible specialist in at least one specialty recognized by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association as applicable

• Prior leadership as a health plan medical or pharmacy benefits management or experience with health systems.
• Exhibit an understanding of Federal health benefits programs pertinent laws regulations claims dispute procedures OPM precedent decision and carrier interpretations.

• Partnering: Ability to develop networks and build alliances engage in cross-functional activities; collaborate across boundaries and find common ground with a widening range of stakeholders. Utilize contacts to build and strengthen internal support bases.
• External Awareness: Demonstrated experience in understanding local national and international policies and trends that affect the organization and shape stakeholders views; is aware of the organizations impact on the external environment.
• Communication:Ability to make clear and convincing oral presentations to individuals or groups; listen effectively and clarify information as needed; facilitate an open exchange of ideas and foster an atmosphere of open communication. Ability to express written facts and ideas in a clear convincing and organized manner.