About this role

To qualify for this position, applicants must meet all requirements by the closing date of this announcement:08/14/2026. TIME-IN-GRADE REQUIREMENT: As a current Federal, GS employee you must meet time-in-grade requirements by the closing date of this announcement. For a GS-11 position you must have served 52 weeks at the GS-10 level. For a GS-12 position you must have served 52 weeks at the GS-11 level. If you are a current VBA employee outside of the commuting area seeking reassignment or change to lower grade via this vacancy announcement, you must currently hold the GS-11 (or higher) and the promotion potential of your current position must be at least GS-12.

The grade may have been in any occupation and must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials. You must provide a copy of your most recent SF-50 that indicates proof of status (career, career-conditional, or excepted service), time-in-grade requirements have been met, and identifies your position title, series, grade, step, salary, tenure, and type of service.

If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate possession of time-in-grade requirements. In this instance, you must also submit your most recent Promotion or Within Grade Increase SF-50, or a Promotion or Within Grade Increase SF-50 that indicates the highest grade/step previously held. DO NOT submit Award SF-50s and/or General Adjustment SF-50s as they cannot be used to verify time-in-grade.

MINIMUM QUALIFICATION REQUIREMENT: You may qualify based on your experience and/or education as described below: GS-11 Grade Level: Specialized Experience: Work that involves performing training, analysis, or information systems duties within a claims management process. Examples include but are not limited to: Conducting evaluations and quality reviews to determine authorization quality and accuracy against established standards; Compiling and presenting quality trend information to management to support decision-making; Developing training materials and delivering training to address identified performance deficiencies; Providing quality-review feedback and guidance to staff to correct unsatisfactory performance.

OR Education Substitution: Applicants must have a Ph.D. or equivalent doctoral degree or three full years (54 semester hours or 81 quarter hours) of progressively higher level graduate education leading to such a degree or LL.M, if related. This graduate education (or completed degree) must demonstrate the knowledge, skills, and abilities (KSAs) to do the work for this position. Note: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

OR Combining Education & Experience: If you do not fully meet the length of experience and education described for a specific grade level (e.g. have six months of experience and some coursework but not a degree), the two can be combined to total 100% of the requirement. Click here for more information. GS-12 Grade Level: Specialized Experience: Work that involves independently performing advanced training, analyst, or information systems duties within a claims management process, with responsibility for identifying systemic issues and recommending program-level solutions.

Examples include but are not limited to: Independently conducting evaluations and quality reviews of authorization actions. Identifies root causes of errors and process weaknesses; Analyzing quality trend data to identify patterns and develop actionable recommendations for performance, process, or training changes. Presents findings and recommendations to management or leadership; Developing, delivering, and evaluating the effectiveness of training materials, including recommending modifications based on outcome data; Analyzing performance deficiencies and quality trends to identify knowledge/skill gaps and developing corrective strategies or interventions to close those gaps; Providing quality-review services, feedback, and guidance to staff, including mentoring or providing technical guidance to less experienced reviewers to correct unsatisfactory performance.

OR Education Substitution: There is no education substitution at the GS-12 grade level. Volunteer Experience: 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; religions; 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. Full vs. Part-Time Employment: Full-time employment is considered to be at least 35 hours per week. Part-time experience will be credited on a pro-rated basis; when including part-time employment in your resume you must specify the average hours worked per week. Physical Requirements: The work normally involves mental rather than physical exertion.

The work is mostly sedentary. However, there may be some walking, standing, and carrying of light items such as papers, books, claims folders, and files from one desk to another or for returning to storage. Carts are utilized to carry large number of claims folders. This will require the incumbent to push or pull the cart from one area to another. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at http://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/.

Source listing: usajobs