Health Insurance Specialist (Data Analysis & Studies) Job at CMS

The Health Insurance Specialist (Data Analysis & Studies) position at the Centers for Medicare & Medicaid Services (CMS) is an opportunity for experienced professionals who want to work in healthcare research, data analysis, and government policy. This full-time federal job offers an advertised annual salary of $112,556 to $163,062, depending on the duty location. The position is classified at the GS-13 level and focuses on Medicare program data, policy research, and operational improvement.

The Health Insurance Specialist (Data Analysis & Studies) role may suit candidates who can study complex information, identify trends, review federal rules, and prepare clear reports. The selected employee will support work connected to Medicare Part C and Part D. These programs play an important role in the U.S. healthcare system, making accurate information and careful analysis essential.

The official announcement lists October 16, 2026, as the application deadline. Applicants should check the official USAJOBS notice to confirm that applications are still being accepted. This position requires U.S. citizenship or U.S. nationality. It is eligible for telework under agency policy, but it is not advertised as a fully remote job.

Health Insurance Specialist (Data Analysis & Studies) Job Overview

The Centers for Medicare & Medicaid Services is part of the U.S. Department of Health and Human Services. The agency administers major public health insurance programs and works with healthcare organizations, government teams, and other partners.

The Health Insurance Specialist (Data Analysis & Studies) vacancy is associated with the Center for Medicare, the Medicare Plan Payment Group, and the Division of Payment Reconciliation. The employee will conduct studies, examine program information, research policy questions, and help improve government operations.

Key Job Details

• Job title: Health Insurance Specialist (Data Analysis & Studies)
• Hiring agency: Centers for Medicare & Medicaid Services (CMS)
• Department: U.S. Department of Health and Human Services
• Job grade: GS-13
• Job series: 0107, Health Insurance Administration
• Annual salary: $112,556–$163,062
• Employment type: Permanent, full-time
• Work schedule: Flexible tour of duty
• Work arrangement: Telework eligible under agency policy; not fully remote
• Travel: Occasional travel may be required
• Announcement number: CMS-CM-27-13084521-DE
• Application deadline: October 16, 2026, at 11:59 p.m. Eastern Time
• Application website: USAJOBS

The advertised salary depends on the duty location. Candidates should review the official vacancy notice for the pay range that applies to their preferred location.

What Does a Health Insurance Specialist (Data Analysis & Studies) Do?

A Health Insurance Specialist (Data Analysis & Studies) studies information that helps the government understand and manage Medicare programs. The job combines research, data analysis, policy review, project coordination, and report writing.

This is not a typical insurance sales position. The employee does not mainly sell insurance plans or process routine customer requests. Instead, the work involves reviewing complex information and helping government teams make decisions based on reliable evidence.

For example, the specialist may examine data to identify unusual patterns, investigate differences between reports, or study how a policy affects program operations. They must check the available evidence before drawing conclusions and explain their findings in clear language.

The role also requires an understanding of federal healthcare rules. A Health Insurance Specialist (Data Analysis & Studies) must connect research findings with program requirements and explain what the results may mean for Medicare operations.

Understanding Medicare Part C and Part D

Medicare is a U.S. health insurance program for eligible people. It serves many adults aged 65 and older, as well as certain younger people who meet specific eligibility conditions.

Medicare Part C is also called Medicare Advantage. It allows eligible people to receive Medicare benefits through approved private health plans. Medicare Part D helps cover prescription drugs through approved plans.

These programs involve enrollment information, reporting requirements, policy rules, and other data. The Health Insurance Specialist (Data Analysis & Studies) position supports studies and policy work related to these areas.

The employee may review enrollment information, encounter data, operational results, and other information relevant to assigned projects. The exact duties will depend on agency needs and the responsibilities outlined in the vacancy.

Main Duties and Responsibilities

The Health Insurance Specialist (Data Analysis & Studies) job involves several major responsibilities. The work requires careful research, attention to detail, and the ability to explain complex findings.

1. Conduct Data Analysis and Research

The employee will plan and conduct complex studies related to Medicare Part D operations and policy, as well as Medicare Part C enrollment and encounter-data operations and policy.

These studies help CMS understand program performance and identify issues that may require further review.

Typical activities may include:

• Reviewing information from different sources.
• Comparing results across groups or time periods.
• Studying changes in program performance.
• Checking whether data supports a proposed conclusion.
• Preparing findings for managers and other teams.

A Health Insurance Specialist (Data Analysis & Studies) must base conclusions on reliable evidence. The specialist should explain what the data shows without claiming that it proves something the evidence cannot support.

2. Validate Data and Identify Trends

Accurate information is essential when government teams make decisions about healthcare programs. The employee will validate and interpret program data to identify trends, differences, data-quality concerns, and operational risks.

For example, two reports may show different results for a similar measure. The specialist may need to compare the information, investigate possible reasons, and explain whether more research is needed.

This work can include checking for missing information, unexpected changes, inconsistent records, or other problems that may affect the results.

The goal is to help CMS rely on dependable information when reviewing Medicare operations and considering improvements.

3. Research Laws and Policy Requirements

Medicare programs operate under federal laws, regulations, and program requirements. The employee will research these rules and examine how they affect operations and data.

A Health Insurance Specialist (Data Analysis & Studies) may need to read policy documents, understand relevant requirements, and explain how they apply to a specific program question.

The employee may also help teams assess whether program activities follow applicable rules or whether a policy issue requires additional review.

Strong reading, research, and analytical skills are important for this part of the job.

4. Lead Projects and Improve Program Operations

The position also involves leading projects that include different teams and stakeholders. These projects may focus on data quality, reporting, operational requirements, business practices, or program performance.

The specialist may help plan project activities, explain the problem, coordinate work, review progress, and share the final results.

Project leadership is important when an issue involves several teams. The employee must help people understand the problem and work toward a practical solution.

5. Prepare Reports and Presentations

The employee will prepare reports, performance measures, briefings, presentations, and recommendations.

These materials help managers and other stakeholders understand research findings and decide what steps may be needed next.

A useful report should explain the question being studied, the information reviewed, the main findings, and any recommendations. It should also identify limits in the available evidence when necessary.

Clear writing matters because some readers may not work directly with data every day. The Health Insurance Specialist (Data Analysis & Studies) must present findings in a way that is accurate and easy to understand.

Health Insurance Specialist (Data Analysis & Studies) Salary

The advertised annual salary for the Health Insurance Specialist (Data Analysis & Studies) position is $112,556 to $163,062. The applicable amount depends on the duty location and federal pay rules.

The official announcement lists the following locality ranges:

• Atlanta, Georgia: $112,556–$146,325 per year.
• Boston, Massachusetts: $120,548–$156,715 per year.
• Woodlawn, Maryland: $121,785–$158,322 per year.
• New York, New York: $125,431–$163,062 per year.
• Seattle, Washington: $119,630–$155,521 per year.

These figures are advertised salary ranges, not a promise that every successful applicant will receive the highest amount. The applicable rate depends on the selected duty location and federal pay rules.

What Does GS-13 Mean?

The General Schedule, or GS, is a federal pay and job classification system used for many civilian government employees. Each grade reflects a level of responsibility and qualification.

This vacancy is listed at GS-13. Applicants must have at least one year, or 52 weeks, of qualifying specialized experience equivalent to the GS-12 level in the federal government.

That requirement makes the position more suitable for experienced professionals than for people seeking their first job in healthcare administration or data analysis.

The announcement does not authorize recruitment or relocation incentives. Applicants who may need to move should consider this when deciding whether to apply.

Health Insurance Specialist (Data Analysis & Studies) Job Locations

The official listing includes several duty locations, including Atlanta, Georgia; Boston, Massachusetts; Woodlawn, Maryland; New York, New York; and Seattle, Washington. It also includes a location option for certain CMS employees who remain at their current duty station.

Candidates should check the location options and application instructions on USAJOBS. Available arrangements may depend on the official announcement and agency rules.

Is the Health Insurance Specialist (Data Analysis & Studies) Job Remote?

The position is not listed as fully remote. The announcement says telework may be available under agency policy and includes a regular and recurring reporting requirement to the CMS office associated with the job.

Telework generally allows an employee to work away from the office under an approved arrangement. A remote position is different because it is advertised without a regular requirement to report to a central office.

Applicants should not assume they can work from any state or country. They should confirm the duty station and workplace rules with the hiring agency before accepting a position.

Qualifications for a Health Insurance Specialist (Data Analysis & Studies)

Applicants must meet the specialized experience requirement for this GS-13 position. The official announcement requires at least one year, or 52 weeks, of qualifying experience equivalent to the GS-12 level.

The experience may come from public-sector or private-sector employment. However, it must match the areas described in the vacancy notice.

Required Specialized Experience

Applicants must demonstrate experience in all four of these areas:

• Designing data studies: Studying how operations and policies affect health insurance programs, including Medicare Advantage (Part C) or Medicare Part D.
• Using analytical methods: Applying qualitative and quantitative methods to identify trends, root causes, and factors affecting health insurance programs or healthcare administration.
• Interpreting Medicare rules: Understanding laws and federal regulations for Medicare Part C or Part D to assess compliance or inform policy decisions.
• Preparing reports: Developing summary reports, briefings, or policy statements that explain findings from data studies.

General experience in healthcare may not be enough on its own. Candidates must show how their work relates to data studies, analysis, Medicare requirements, and reporting.

Important Skills for This Position

The duties of a Health Insurance Specialist (Data Analysis & Studies) require both technical and communication skills.

Useful skills include:

• Data analysis and research.
• Healthcare or health insurance policy knowledge.
• Understanding of Medicare programs.
• Reading laws, regulations, and policy documents.
• Identifying trends and possible causes.
• Writing reports and recommendations.
• Managing projects across teams.
• Explaining technical findings in simple language.
• Checking information for accuracy and completeness.

Candidates should describe only the skills they actually have and support their claims with examples from their work history.

Is a College Degree Required?

The official announcement does not list a separate education qualification requirement. Applicants must still meet the specialized experience standard and provide the documents requested in the vacancy notice.

Candidates should read the complete qualifications section instead of assuming that a degree alone will qualify them.

Who Can Apply for This Federal Job?

The Health Insurance Specialist (Data Analysis & Studies) vacancy requires applicants to be U.S. citizens or U.S. nationals. The announcement also identifies certain eligible federal career-transition applicants under programs such as CTAP and ICTAP.

Applicants using these hiring paths must meet the relevant eligibility rules and provide the required supporting documents.

Can International Applicants Apply?

This specific vacancy requires U.S. citizenship or U.S. nationality. People who do not meet that requirement should not assume they are eligible simply because the announcement is publicly available online.

International job seekers interested in healthcare data or policy work should look for other vacancies whose eligibility requirements match their citizenship and work authorization status.

Background Checks and Other Conditions

The selected candidate will be subject to a background and suitability investigation. A one-year probationary period may also be required.

The announcement includes a Selective Service requirement for male applicants born after December 31, 1959, unless they qualify for an exemption. Federal employment eligibility documents will also be verified through E-Verify.

Candidates should review the conditions of employment and confirm that they can meet the applicable requirements.

Documents Needed to Apply

A clear, complete resume is essential for the application. The official announcement limits resumes to two pages or less.

Applicants should follow the specific instructions in the vacancy rather than submit a longer resume.

Your resume should include:

• Job titles and relevant federal series and grade, if applicable.
• Employer names and addresses.
• Specific duties and responsibilities.
• Employment start and end dates in month and year format.
• Whether the role was full-time or part-time.
• Hours worked per week.
• Salary information.
• Relevant education and any other requested details.

Depending on the applicant’s eligibility, additional documents may be required, such as an SF-50, DD-214, or SF-15. These documents do not apply to every candidate, so check the official list of required documents.

How to Present Your Experience

Use real examples to show how your previous work matches the vacancy requirements. Explain the type of study or analysis you completed, the methods you used, and the results or recommendations you produced.

Instead of writing only that you worked with healthcare data, describe the actual research or data review you performed and how it supported a decision, if that accurately reflects your experience.

Do not copy the vacancy description into your resume without showing evidence of your own work. The hiring agency warns that copied wording without clear details about an applicant’s experience can lead to an ineligible rating.

How to Apply for the Health Insurance Specialist (Data Analysis & Studies) Job

Applications must be submitted through the official USAJOBS process. Follow these steps carefully.

1. Open the official vacancy announcement.
2. Review the duties, salary, locations, qualifications, and eligibility rules.
3. Sign in to USAJOBS or create an account.
4. Prepare a resume that meets the two-page limit.
5. Gather the supporting documents required for your eligibility category.
6. Complete the application questionnaire and other required questions.
7. Submit the application before the closing time.
8. Check your USAJOBS account and email for updates or assessment instructions.

The announcement requires an online assessment in addition to the application and questionnaire. If you are asked to complete an assessment, follow the instructions and deadline provided by the hiring system.

Application Deadline

The listed closing date for the Health Insurance Specialist (Data Analysis & Studies) position is October 16, 2026, at 11:59 p.m. Eastern Time.

Because federal vacancy details can change, applicants should check the official announcement before applying. Do not rely only on third-party job websites to confirm whether applications are still being accepted.

Benefits and Career Opportunities

This is a permanent, full-time federal position. The vacancy links to information about federal employee benefits, but the benefits available to an individual depend on the applicable employment rules and appointment details.

The role may provide experience in government healthcare policy, Medicare data analysis, program research, and operational improvement. These areas may be relevant to professionals interested in public administration, healthcare policy, health insurance, or government research.

The position also involves working with other teams and stakeholders. This can help experienced professionals develop project leadership, research communication, and policy analysis skills.

However, candidates should review the duties and requirements carefully. The vacancy is intended for people with relevant experience rather than applicants seeking an entry-level healthcare position.

Tips for a Strong Application

A strong application makes it easier for the hiring team to understand your qualifications. Use these tips to prepare your materials.

Match Your Resume to the Required Experience

Review all four specialized experience areas in the announcement. Make sure your resume clearly explains how your previous work meets each requirement.

Use Specific Examples

Describe projects, data studies, policy reviews, and reports you have completed. Explain your role and the results without sharing confidential information.

Follow the Resume Instructions

Keep your resume within the two-page limit and include the employment details requested in the announcement. Missing information may make it harder for the hiring team to assess your experience.

Answer Questions Honestly

Your questionnaire answers should match your actual experience and resume. Do not exaggerate your skills or claim experience you cannot demonstrate.

Submit Before the Deadline

Prepare your documents early and leave enough time to review the application. If an online assessment is required, follow the agency’s instructions about when and how to complete it.

Frequently Asked Questions About the Health Insurance Specialist (Data Analysis & Studies) Job

What Is the Salary for the Health Insurance Specialist (Data Analysis & Studies) Job?

The advertised salary range is $112,556 to $163,062 per year. The applicable amount depends on the duty location and federal pay rules. Check the official announcement for the range associated with your selected location.

What Does a Health Insurance Specialist (Data Analysis & Studies) Do at CMS?

The employee studies Medicare data and policy issues, identifies trends and data-quality problems, researches program requirements, leads improvement projects, and prepares reports and recommendations.

What Qualifications Are Required for the Health Insurance Specialist (Data Analysis & Studies) Position?

Applicants must show at least one year of qualifying specialized experience equivalent to GS-12. The experience must cover data studies, analytical methods, Medicare rules, and report writing as described in the official vacancy.

Is the Health Insurance Specialist (Data Analysis & Studies) Job Fully Remote?

No. The vacancy is telework eligible under agency policy, but it is not advertised as fully remote. The announcement includes a regular and recurring reporting requirement to a CMS office.

Can Applicants Outside the United States Apply for This Job?

The vacancy requires U.S. citizenship or U.S. nationality. Applicants who do not meet that requirement should look for other jobs whose eligibility rules fit their circumstances.

Is a College Degree Mandatory for the Health Insurance Specialist (Data Analysis & Studies) Job?

The announcement does not list a separate education qualification requirement. Candidates must meet the specialized experience requirement and provide the documents requested by the hiring agency.

When Is the Application Deadline?

The listed closing date is October 16, 2026, at 11:59 p.m. Eastern Time. Confirm the deadline and vacancy status on the official USAJOBS page before applying.

Where Can I Apply for the Health Insurance Specialist (Data Analysis & Studies) Position?

Use the official vacancy announcement on USAJOBS. Review the eligibility requirements and application instructions, then submit your documents through the official process.

Job Summary and Application Checklist

The Health Insurance Specialist (Data Analysis & Studies) position at CMS is a senior federal opportunity for experienced professionals in healthcare data analysis, Medicare policy, and program research. It offers an advertised annual salary of $112,556 to $163,062 and is classified at the GS-13 level.

Before applying, make sure you have checked these points:

• You meet the U.S. citizenship or nationality requirement.
• You have the required specialized experience.
• Your resume follows the two-page limit.
• You have gathered all documents required for your eligibility category.
• You understand the duty location and telework rules.
• You have checked the application deadline and assessment instructions.

Apply Through the Official Website

Read the complete vacancy announcement and apply through USAJOBS:

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