U.S. Office of Personnel Management Office of Merit Systems Oversight and Effectiveness Classification Appeals and FLSA Programs Philadelphia Oversight Division 600 Arch Street, Room 3400 Philadelphia, PA 19106-1596 Classification Appeal Decision Under section 5112 of title 5, United States Code Appellant: [appellant’s name] Agency classification: Health Insurance Specialist GS-107-13 Organization: [name] Group Center for [name] Center for Medicare and Medicaid Services Department of Health and Human Services Baltimore, Maryland OPM decision: Health Insurance Specialist GS-107-13 OPM decision number: C-0107-13-01 /s/ Robert D. Hendler _____________________________ Robert D. Hendler Classification Appeals Officer August 8, 2002 _____________________________ Date As provided in section 511.612 of title 5, Code of Federal Regulations (CFR), this decision constitutes a certificate that is mandatory and binding on all administrative, certifying, payroll, disbursing, and accounting officials of the government. The agency is responsible for reviewing its classification decisions for identical, similar, or related positions to ensure consistency with this decision. There is no right of further appeal. This decision is subject to discretionary review only under conditions and time limits specified in the Introduction to the Position Classification Standards (PCS’s), appendix 4, section G (address provided in appendix 4, section H). Decision sent to: [appellant’s name]Michael Patrick Keogh [appellant’s address]939 Wilton Drive Baltimore, Maryland 21227 Mr. Ernest O. Tucker Director, Human Resources Management Group Centers for Medicare and Medicaid Services Department of Health and Human Services 7500 Security Boulevard Baltimore, MD D 21242-1850 Ms. Evelyn M. White Deputy Assistant Secretary for Human Resources Department of Health and Human Services HHH Building 200 Independence Avenue, S.W. Washington, DC 20201 Introduction On April 1, 2002, the Philadelphia Oversight Division of the U.S. Office of Personnel Management (OPM) accepted a classification appeal from [appellant’s name]Mr. Michael Keogh. His position is currently classified as Health Insurance Specialist, GS-107-13. He believes the classification should be Lead Health Insurance Specialist, GS-107-14. The appellant appealed to his agency, which issued its final decision on December 14, 2001. He works in the [name] Group, Center for [name] ([acronym]), Center for Medicare and Medicaid Services (CMS), Department of Health and Human Services, Center for Medicare and Medicaid Services, Center for Medicaid and State Operations, Policy Coordination and Planning Group, Baltimore, MDaryland. We received the complete appeal administrative report on April 22, 2002. We have accepted and decided his appeal under section 5112 of title 5, United States Code (U.S.C.). General Issuesissues The appellant statedbelieves that his position should be credited at Level 2-5, resulting in reclassification to the GS-14 grade level. In his March 28, 2002, letter, he provided descriptions of work supporting his rationale. He claims that the agency did not adequately consider this documentation and credible sources in either the initial review or the subsequent appeal. He saidtated that he is the DRP (Drug Rebate Program) (DRP) team leader with and has complete responsibility for determining the appropriateness of resolutions of disputes involving millions of dollars between pharmaceutical manufacturers and State mMedicaidMedicaid aAgencies. He said that he is theAs the lead mediator, he stated that he had on those agreements and has final signnatory off responsibility for the agency on those agreements. The appellantHe stated said that his supervisor is not has never been involved in any at DRP meetings, negotiations, or settlements, and that. At no time did he and hisor any of his team members do notever seek technical involvement from his supervisor. He said thatbelieves that he has been delegated full technical authority because he has been assigned the duties of team leader for the DRP and the nature of those duties, and that his supervisor is not technically qualified and has played no technical role in the program. The appellant stated that there is an absence of a technically qualified supervisor whodoes not exercises substantial program control, such as, analyzing [ program] policies,; formulating policies which govern the program,, issuing policy statements,, establishing procedures for efficient operations of the program, and giving program guidance. Instead, the appellant said that he performs these functionsRather, all of the above are performed by him as the DRP tTeam lLeader without any technical guidance, input or technical review by his supervisor. The appellant’s March 28, 2002, appeal letter, provided descriptions of work supporting his rationale. He claims that the agency did not adequately consider this documentation and credible sources in either the initial review or the subsequent appeal. He claims that his PD inadequately describes his duties as Team Leader. He further believes that the description of the technical authority over the program area assigned to him is inaccurate and distorts the fact that he performs all aspects of technical authority in the assigned area. By law, we must classify positions solely by comparing their current duties and responsibilities to OPM PCS's and guidelines (5 U.S.C. 5106, 5107, and 5112). Other methods or factors of evaluation are not authorized for use in determining the classification of a position, such as comparison to positions they may have been properly classified. Because our decision sets aside all previous agency decisions, the appellant’s concerns regarding his agency’s classification review process are not germane to this decision. The appellant said that his position description (PD) does not adequately describe his team leader duties. He stated that the description of the technical authority over the program area assigned to him is inaccurate and distorts the fact that he has full technical authority. A PD is the official record of the major duties and responsibilities assigned to a position by an official with the authority to assign work. A position is the duties and responsibilities that make up the work performed by an employee. Position classification appeal regulations permit OPM to investigate or audit a position and decide an appeal on the basis of the actual duties and responsibilities assigned by management and performed by the employee. An OPM appeal decision grades a real operating position and not simply the PD. Therefore, this decision is based on the actual work assigned to and performed by the appellant. Position information The appellant serves as the primary staff member in CMS with responsibileity for managing the Dispute Resolution Program as it pertains directly to Medicaid’s Drug Rebate Program. The DRP is a successful national health insurance program which , for which, the appellant helped is given considerable credit for leading its design and implementation during the mid 1990’s. The Dispute RResolution Program is a cost effective method of assisting Sstates and pharmaceutical manufacturers toin resolveing disputed rebate payments. Resolutions are reached through meetings of both sides with CMS staff as mediators. The appellant and a matrix team of 10 staff in other CMS offices work together for a specified DRP project. Each member is focused on a specific issue, (e.g., data collection, correspondence) and functions independently function on their own. They contact the appellant for his technical adviceexpertise and to keep him abreast of all the issues. The appellant and an ad hoc team of 10 experienced staff in other CMS offices oversee the DRP for CMS. The appellant is responsible for actively exploring developing other areas in the overall Medicaid program where dispute resolution methods and procedures might prove effective. and successful. As part of the appeal administrative report process, the appellant’s position description (PDD) of record (PD # [number]240040) was revised. The appellant’s immediate supervisor certified the accuracy of the revisednew PD on October 16, 2001. Agency management has certified that the appellant’s position description of record (# 240040) is accurate. We conducted a telephone audits with the appellant on July 2 and 31, 2002, and a telephone interview with the appellant’s immediate supervisor, [name]Mary Beth Hance, Director, [name]Policy coordination and Planning Group, [acronym]CMSO, on July 17., 2002; We conducteda telephoneic interviews with others knowledgeable of the CMS regional DRP operations including on July 18, 2002 with [name]Tami Bruce and [name], Health Insurance Specialist and Diane Dunstan, Health Insurance Specialists,; anda [name]telephone interview on July 18, 2002 with Dave Selleck, Supervisor, [name]State Programs Branch, o; a telephonic interview on July 18; July 30, [name]2002 with Rick Freeman, Director of [name]State Divisions, on July 30; a telephone interview on July 31, 2002 with and [name]Sue Williams, Health Insurance Specialist, on July 31. In deciding this appeal, we fully considered the audit and interview findings and all information of record furnished by the appellant and his agency. Our audit with the appellant and our interview with his supervisor and other staff members confirmed that the PD of record contains the major duties and responsibilities performed by the appellant which we incorporate by reference into this decision. Series and title determination The agency placed the appellant’s position in the Health Insurance Specialist Series, GS-107, for which there is a published PCS, and titled it Health Insurance Specialist. The appellant did not disagree with these determinations, and we agree. Therefore, the appealed position is allocated properly as Health Insurance Specialist, GS-107. Standard determination The GS-107 series does not have published grade level criteria. The agency applied the Administrative Analysis Grade Evaluation Guide (AAGEG) for grade level evaluation. The appellant did not disagree. The Introduction to the PCS’s states that when there is no directly applicable PCS, a position should be classified using criteria that are comparable in scope and difficulty, and that describe similar subject matter and functions. The Social Insurance Administration Series, GS-105, belongs to the same occupational family as the appellant’s position and shares similar characteristics in terms of the required analytical, writing, and judgmental skills. While the GS-105 PCS describes Government social program administration work related to the appellant’s own, it does not contain certain factor level criteria necessary to address the appellant’s grade level concerns. The AAGEG contains criteria designed to evaluate staff analytical duties of positions primarily engaged in program administration. Because it offers criteria germane to the appellant’s program development and administration work at levels above those defined in the GS-105 PCS, the AAGEGit will be used to extend the criteria of the GS-105 PCS as required in the Introduction to the PCS’s. General Schedule Leader Grade Evaluation Guide The appellant’s appeal rationale is thatcontents that he spends the majority of his time functioning in the role of a team leader for 10 CMS regional office staff who perform DRP duties. He statesfurther contends that he makes assignments, stays abreast of the status and progress of the work being performed, sets deadlines and work requirements, provides specific instructions for completing work, and provides final review for all assignments. The appellantHe also indicated t said that he nominates or recommends team members for awards and provides performance evaluations to the respected manager. Implicit in the appellant’s rationale is that his The appellant’s duties as a team leader duties are covered by the General Schedule Leader Grade Evaluation Guide (GSLGEG). are responsible and demanding, but they must be carefully examined to determine whether they are appropriately classified under the GSLGEG. The GSLGEG,re are many different types of leader positions in the Federal workplace today, and the distinction between team leaders classifiable under GSLGEG and other types of leadership positions is not always clear. To understand the intended coverage of the guide must be read and construed as a whole. Part II, covers positions that spend at least 25 percent of their duty time leading a team of other General Schedule employees in accomplishing two-grade interval work. As discussed The Exclusions, under Notes to Users, and the Occupational Information sections of the guide jointly circumscribe its intended coverage. The guidance in these sections of the GSLGEG indicates that the guide, the GSLGEG is intended to be used to grade team leader positions that evolved with the Governmentwide effort to reduce the number of supervisory positions. Thus, Tteam leaders covered by the GSLGEG function as “alternatives to traditional supervision,” and support delayering and reductions in supervisory levels over a. Accordingly, it can reasonably be concluded that the GSLGEG is applicable to positions that have responsibility for a permanently assigned group of employees for which both technical and administrative leadership responsibilities are performed on a continuing basis. The Exclusions section of the GSLGEG states thatpecifically excluded positions whichthat have functional “project” responsibility but do not lead other workers on a continuing basis and positions that lead cross-functional matrix teams are not covered by the GSLGEG. While the appellant may spend a considerable amount of time performing in a leadership role, with other employees, his position is work is covered by the clearly project exclusiondriven. The appellant does not have continuing responsibility for leading a permanently assigned group of employees. Rather, he leads matrixad hoc teams that are formed to work on drug dispute resolution issues arising between the Sstates and drug manufacturers. Decisions as to the composition of the teams are made when teams are formed with consideration being given to such factors as availability of staff, past experience, and complexity of the assignment. All of the employees who work on the drug dispute resolution issues are overseen by their respective managers and have specific roles related to dispute resolution. The appellant may ask if they have time to complete the project at hand, but it is the individual managers who are responsible for the assigned work. Each team member functions independently and only contacts the appellant when necessary. The appellant has no line control over team members. The appellant does not approve leave. He, and makes recommendations for awards under the peer recognition program, not as part of the line award nomination process. Because the While the appellant’s team leader may perform some duties similar to those of a team leader, these duties do not meet the criteria for classification under the GSLGEG, we may not apply that PCS for grade determination purposes. Grade determination The GS-105 PCS and AAGEG are written in the Factor Evaluation System (FES) format. Positions graded under the FES format are compared to nine factors. Levels are assigned for each factor and the points associated with the assigned levels are totaled and converted to a grade level by application of the Grade Conversion Table contained in the PCS. Under the FES, factor level descriptions mark the floor threshold for the indicated factor level. If a position fails in any significant aspect to meet a particular level in the standard, the next lower level and its lower point value must be assigned, unless the deficiency is balanced by an equally important aspect that meets a higher level. The agency credited Levels 1-8, 3-5, 4-5, 5-5, 6/7 3d-3,, 7-d, 8-1, and 9-1. After careful analysis of the record, we concur with the agency’s analysis of the uncontested factor levels and have so credited the position. The appellant believes that his position should be credited at Level 2-5, our . Our analysis of whichFactor 2 follows. Factor 2, Supervisory cControls “Supervisory Controls” covers the nature and extent of direct or indirect controls exercised by the supervisor, the employee’s responsibility, and the review of completed work. Controls are exercised by the supervisor in the way assignments are made, instructions are given to the employee, priorities and deadlines are set, and objectives and boundaries are defined. Responsibility of the employee depends upon the extent to which the employee is expected to develop the sequence and timing of various aspects of the work, to modify or recommend modification of instructions, and to participate in establishing priorities and defining objectives. The degree of review of completed work depends upon the nature and extent of the review, e.g., close and detailed review of each phase of the assignment; , detailed review of the finished assignment,; spot-check of finished work for accuracy,, or review only for adherence to policy. Both Levels 2-4 and 2-5 describe positions of highly skilled personnel who carry out their work largely independently. At Level 2-4, the employee works within a program framework and receives project assignments. In contrast, Level 2-5 includes program authority with the employee responsible for designing the plans and strategies by which broad projects will be undertaken, including studies or other major program functions. At Level 2-4, work receives some degree of technical review for feasibility of the program approach. In contrast, review at Level 2-5 is for broader considerations such as impact on the overall program and achieving the functional program’s objectives.At level 2-5, the level of review of work primarily is administrative, focusing on such matters as broad agency policy objectives and general program direction rather than on the technical aspects of the work, such as whether agreements are technically feasible or whether mediation can be accomplished within a reasonable amount of time. Full technical authority is delegated to the employee. The exercise crediting of technical supervision byto a position does not mean that the supervisor must be as skilled as the subordinate in a subject matter area. For example, supervisory scientists and engineers routinely supervise employees in highly specialized professional positions in which they are not fully credentialed. As technical supervisors, however, they have authority and responsibility to accept, reject, or direct that the work beis modified to meet program requirements. The Director, [name]Policy Coordination and Planning Group, position is vested with both technical and administrative control over the ADRPR program. Although the appellant’s first and second level supervisors do not provide technical guidance to the appellant, they are held both technically and administratively responsible for the appellant’s program as reflected in his performance standards and have responsibility for accepting or rejecting work. In the appellant’s case, this included determining how well the ADR program is meeting defined management needs. This clearly exceeds the type of administrative supervision normally expected at Level 2-5. In addition, the appellant’‘s work cannot be said to be technically authoritive in that his position is not assigned the authority upon which this would be predicated. For example, mediation agreements do not have to be signed by the appellant nor is he granted any authority on which to make an agreement. Signing memoranda on technical issues does not constitute the exercise of Level 2-5 authority. Work examples provided by the appellant confirm that his work is subject to more than administrative review.shows that he is involved in the technical issues decisions. The appellant’s program authority is also limited by the three levels of local supervision under which he works. Although the appellant’s first and second level supervisors do not provide technical guidance to the appellant, they are held both technically and administratively responsible for the appellant’s program as reflected in his performance standards. Technical supervision included the responsibility of accepting or rejecting work. In the appellant’s case, this included determining how well the ADR program is meeting defined management needs. Neither the absence of immediate supervision for day-to-day operations, nor the fact that technical recommendations normally are accepted, serves to support a level above Level 2-4. Accordingly, this factor is creditedevaluated properly at Level 2-4 (450 points). Summary In summary, we have credited the position as follows: Factors Level Points 1. Knowledge required by the position 1-8 1,550 2. Supervisory controls 2-4 450 3. Guidelines 3-5 650 4. Complexity 4-5 325 5. Scope and effect 5-5 325 6. Personal contacts and 7. Purpose of contacts 3-d 280 8. Physical demands 8-1 5 9. Work environment 9-1 5 Total Points 3,590 A total of 3,590 falls within the GS-13 grade level point range of 3,155-3,600 points in the Grade Conversion Table. Our analysis fully considers the appellant’s publications, and input from external parties knowledgeable of his work. This information was instrumental in supporting the factor levels credited above. Decision The appellant’s position is properly classified as Health Insurance Specialist, GS-107-13.