RCMJobs ← All Jobs Post a Job
Supervisory Health Insurance Specialist (Division Director)
Centers for Medicare & Medicaid Services
πŸ“ Denver, Colorado On-site Prior Authorization Posted 2026-03-31
πŸ’° $164,956 – $197,200
Apply Now β†’

Opens Centers for Medicare & Medicaid Services's application page directly.

Job Description

ALL QUALIFICATION REQUIREMENTS MUST BE MET WITHIN 30 DAYS OF 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 being considered further. In order to qualify for the GS-15 grade level, 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-14 grade level in the Federal government, obtained in either the private or public sector, to include: 1) Developing or implementing Medicaid prescription drug policies and programs in one or more of the following subject matters: the Medicaid Drug Rebate Program, Medicaid coverage and payment policy for prescription drugs, classification of drugs, Federal Upper Payment Limits, drug utilization review, prior authorization, or preferred drug lists; AND 2) Providing technical direction to staff engaged in such work, OR providing technical assistance to states, manufacturers or other stakeholders implementing such programs; AND 3) Preparing technical and non-technical documents such as briefing documents, analytical reports, standard operating procedures, guidelines, issue papers, or administrative and management reports. 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. Time-in-Grade: To be eligible, current Federal employees 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. Click the following link to view the occupational questionnaire: https://apply.usastaffing.gov/ViewQuestionnaire/12920941
A Day in the Life: Prior Authorization
Full Career Guide β†’
7:00 AM
Review the surgical and procedure schedule for the next 48–72 hours. Every case that requires authorization needs to be cleared be…
7:30 AM
Pull the PA worklist. Filter by date of service β€” cases with the earliest service dates get worked first. High-cost procedures (su…
8:30 AM
Submit PA requests to payers. Each payer has its own portal, its own forms, its own documentation requirements. You know them all…
See salary ranges, certifications, and full career path β†’

Stay ahead of the payer policy changes driving every trend in this job market.

RevCycleAI β€” Free daily RCM intelligence β†’