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Summary As a Program Manager (Disputed Claims) at the GS-0340-15, you will be part of Healthcare and Insurance, Office of Personnel Management. If selected, you will be responsible for directing the Disputed Claims Team operations, including the scheduling, achievement, and performance review of the team. Responsibilities Provides overall leadership for group planning, organizing, mentoring, and overseeing operations of the Disputed Claims office. Lead the procurement for the Independent Review Organization (IRO) contract for medical consultant reviews. Develops and evaluates standard operating procedures on disputed claims operations. Represents OPM in meetings with officials of other Federal agencies, public and private sector organizations, carriers or insurance companies. Requirements Conditions of Employment 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 not eligible for inclusion in a bargaining unit. Qualifications For the GS 15: You must have one full year of specialized experience comparable in scope and responsibility to the GS-14 level in the Federal service (obtained in public or private sectors), which includes performing ALL the following activities: Provide management oversight and control over a team adjudicating disputed claims; Ensure disputed claims process is in accordance with statutory and regulatory requirements; Handle staff and other complaints, settling disagreements and resolving conflicts; AND Review communications and letters on health benefits claims. Merit promotion applicants must meet the time-in-grade requirement as defined in 5 CFR 300, Subpart F. One year at the GS-14 level is required to meet the time-in-grade requirements for the GS15 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. Education Additional Information Relocation expenses will not be paid. Current OPM employees may qualify as an exception. Incentive payments may be considered. This job opportunity announcement may be used to fill additional similar vacancies across OPM. During the application process you will have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions. Veterans Employment Opportunity Act (VEOA): To be eligible for a VEOA appointment under Merit Promotion procedures, the veteran must be a preference eligible or a veteran separated after 3 years or more of continuous active service performed under honorable conditions. Noncompetitive Appointment Authorities: For more information on noncompetitive appointment authority eligibility requirements visit the following websites: Persons with Disabilities-Schedule A Special Hiring Authorities for Veterans Special Hiring Authority for Certain Military Spouses Other Special Appointment Authorities Males born after 12-31-59 must be registered or exempt from Selective Service (see https://www.sss.gov/Home/Registration) Reasonable Accommodation Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request an RA in your online application. Requests for RA for the USA Hire Competency-Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency-Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency-Based Assessments if you received the link after the close of the announcement. To determine if you need an RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments here: https://help.usastaffing.gov/Apply/index.php?title=Reasonable_Accommodations_for_USA_Hire