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Health System Specialist (Integrity and Compliance Auditor)
$55k-73k (estimate)
Full Time 1 Month Ago
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US Veterans Health Administration is Hiring a Remote Health System Specialist (Integrity and Compliance Auditor)

Duties

MAJOR DUTIES:
  • Performs functions associated with the initial and continued development and oversight of the
facility Integrity and Compliance Program
  • Collaborates with the facility Integrity and Compliance Officer (ICO) in planning, developing, and
implementing programs to effectively identify, plan, assess, respond, and monitor areas of high
risk, and coordinate efforts to improve performance as deemed necessary while performing
VHA and other mandated audits and reviews of compliance program areas.
  • Provide audits and analyses of data entered into clinical systems, including but not limited to
CPT codes, encounter documentation, enrollment data, means testing and workload
  • Provides educational assistance to facility staff under the direction of the Integrity and
Compliance Officer.
  • Developing and reviewing procedures and methodologies to ensure accuracy of
reimbursement, insurance information, enrollment reliability and other compliance related
data,
  • Providing answers to difficult technical questions regarding coding and analysis and
resolve coding discrepancies.
  • Providing feedback to physicians and staff concerning medical record documentation
  • Serving as technical advisor and resource person and/or liaison with the medical staff on
questions relating to medical record documentation, coding, enrollment, insurance,
means testing and reimbursement issues
  • Compiles and maintains appropriate management reports and committee minutes
  • Assists in maintaining good communications between the OIC Office and VA staff
  • Provides technical assistance to the ICO in the selection of focused audits, criteria
development, data retrieval, compilation of findings, and follow-up audits oriented toward
improved utilization of resources including cost effectiveness
  • Continues education to keep abreast of new developments and policy changes that
affect the Integrity and Compliance Program and recommends revisions of the technical
aspects of these programs to meet these new demands.
  • Provides staff support to the Integrity and Compliance Committee and Command Suite.
  • Participates in discussions, develops agenda content for recurring meetings and
prepares meeting minutes.
  • Creates communication processes and tools that are flexible, customizable, and
interactive to address the health care system's unique compliance challenges and
education/training needs.
Work Schedule: Monday-Friday 7:00am -3:30pm
Telework: VA supports the use of telework as a way to help attract and retain talented individuals in public service, increase worker productivity, and better prepare the agency to operate during emergencies. This position may be authorized for telework. Telework eligibility will be discussed during the interview process.
Position Description/PD#: Health System Specialist (Integrity and Compliance Auditor)/PD06379O

Requirements

Conditions of Employment

  • You must be a U.S. Citizen to apply for this job
  • All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
  • Selective Service Registration is required for males born after 12/31/1959
  • You may be required to serve a probationary period
  • Subject to background/security investigation
  • Selected applicants will be required to complete an online onboarding process
  • Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP)
  • Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) - See "Additional Information" below for details.

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 08/09/2024.
Time-In-Grade Requirement: Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also 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-09. The grade may have been in any occupation, but 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. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade. Note: Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment.
You may qualify based on your experience and/or education as described below:
  • Specialized Experience: At least one (1) full year of specialized experience equivalent to at least the next lower grade level (GS-9) in the Federal Service that has given you the particular knowledge, skills and abilities required to successfully perform the duties of this position. Specialized experience includes: lead or supervisory experience such as directing the work of subordinates, managing performance, handling employee complaints, reviewing training needs, etc.; experience assisting with a variety of management services essential to the operation of a program or office/organization; has a working knowledge of budget/fiscal management and human resources/personnel management; ensuring compliance with established policies, practices and procedures; and communicating and collaborating with individuals with varied backgrounds and different situations. NOTE: Experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. OR,
  • Education: Successful completion of a Ph.D. or equivalent doctoral degree or 3 full years of progressively higher-level graduate education leading to such a degree, from an accredited college or university. Such education must demonstrate the knowledge, skills and abilities necessary to do the work of this position. NOTE: Transcripts (unofficial or official) must be submitted with your application materials. Education cannot be credited without documentation. OR,
  • Combination: Equivalent combination of successfully completed graduate level education (beyond the second year) and specialized experience, as described above, which may be used to meet total experience requirements for this grade level. The education portion must include graduate courses that demonstrate the knowledge, skills and abilities necessary to do the work of position and must have been obtained in an accredited college or university. NOTE: Transcripts (unofficial or official) must be submitted with your application materials. Education cannot be credited without documentation .
You will be rated on the following Competencies for this position:
  • Interpersonal Skills
  • Negotiation
  • Planning and Evaluating
  • Project Management
  • Reasoning
  • Technical Competence
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.
Note: A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment.
Physical Requirements: The regular and recurring work of this position is mostly sedentary and involves sitting at a desk and working with a computer screen and keyboard. The position requires the ability to move from one geographic location of the facility to another and walking, standing, bending, climbing stairs, and carrying some light items. Stamina and concentration to meet crucial deadlines is required.
The work is performed in a typical office setting, possibly shared office. The office will be within the physical structure of the hospital or one of its surrounding structures as well as Community Based Outpatient Clinics. The work area is usually adequately lighted, heated, and ventilated. This position is eligible for telework.
For more information on these qualification standards, please visit the United States Office of Personnel Management's website at https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/.

Education


A transcript must be submitted with your application if you are basing all or part of your qualifications on education.
Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

Additional information

Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer (TJO). Please visit the Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP), va.gov/EMPLOYEE/docs/The-Fair-Chance-to-Compete-Act.pdf for more information.
The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced Federal/VA competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation (a copy of the agency notice, your most recent performance rating, and your most recent SF-50 noting current position, grade level, and duty location) and be found well-qualified for this vacancy. To be well-qualified: applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the required competencies of the job. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website at http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/.
This job opportunity announcement may be used to fill additional vacancies.
If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement.

  • Benefits

    A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.

    Review our benefits

    Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.

How You Will Be Evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

Your qualifications will be evaluated based on your application materials (e.g., resume, supporting documents), your responses on the application questionnaire, and your responses to all assessments required for this position. You will be assessed on the following Competencies for this position:

  • Interpersonal Skills
  • Negotiation
  • Planning and Evaluating
  • Project Management
  • Reasoning
  • Technical Competence
USA Hire Assessments include a cut score based on the minimum level of required proficiency in these critical general competencies. You must meet or exceed the cut score to be considered. You will not be considered for the position if you score below the cut score or fail to complete the assessment.
Your experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Overstating your qualifications and/or experience in your application materials or application questionnaire may result in your removal from consideration. Cheating on the online assessment may also result in your removal from consideration.
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.
During the application process you may 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 and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members.
  • Benefits

    A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.

    Review our benefits

    Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.

  • Required Documents

    As a new or existing federal employee, you and your family may have access to a range of benefits. Your benefits depend on the type of position you have - whether you're a permanent, part-time, temporary or an intermittent employee. You may be eligible for the following benefits, however, check with your agency to make sure you're eligible under their policies.

    To apply for this position, you must provide a complete Application Package which includes:

    • Resume
    Other accepted documents:
    • Cover Letter
    • DD-214/ Statement of Service
    • Disability Letter (Schedule A)
    • Disability Letter (VA)
    • License
    • Other (1)
    • PCS Orders
    • Performance Appraisal
    • Professional Certification
    • Resume
    • Separation Notice (RIF)
    • SF-15
    • SF-50/ Notification of Personnel Action
    • Transcript
    Please review the above list(s) to ensure you have included all necessary documents required for your application. Not every applicant will require the same documents, therefore it is the applicants responsibility to ensure that their application package includes all necessary documents to determine qualifications and eligibility for appointment, such as a copy of your SF-50, transcript, ICTAP/CTAP documentation (for displaced Federal employees). Applicants will be deemed ineligible if supporting documentation is not submitted. You will not be contacted for additional information.
    Veterans' Preference: Since the Direct-Hire Recruitment Authority is being used, traditional Veterans' Preference rules do not apply. Qualified veterans will, however, be given full consideration for this position.
    It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.
    NOTE: Participation in the seasonal influenza program is a condition of employment and a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). It is a requirement that all HCP to receive annual seasonal influenza vaccination or obtain an exemption for medical or religious reasons. Wearing a face mask is required when an exemption to the influenza vaccination has been granted. HCP in violation of this directive may face disciplinary action up to and including removal from federal service. HCP are individuals who, during the influenza season, work in VHA locations or who come into contact with VA patients or other HCP as part of their duties. VHA locations include, but are not limited to, VA hospitals and associated clinics, community living centers (CLCs), community-based outpatient clinics (CBOCs), domiciliary units, Vet centers and VA-leased medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation, full- and part-time employees, intermittent employees, fee basis employees, VA contractors, researchers, volunteers and health professions trainees (HPTs) who are expected to perform any or all of their work at these facilities. HPTs may be paid or unpaid and include residents, interns, fellows and students. HCP also includes VHA personnel providing home-based care to Veterans and drivers and other personnel whose duties put them in contact with patients outside VA medical facilities.
    Special Employment Consideration: VA encourages persons with disabilities to apply, including those eligible for hiring under 5 CFR 213.3102(u), Schedule A, Appointment of persons with disabilities [i.e., intellectual disabilities, severe physical disabilities, or psychiatric disabilities], and/or Disabled veterans with a compensable service-connected disability of 30% or more. Contact the Agency Contact for information on how to apply under this appointment authority via the Selective Placement Coordinator.

    If you are relying on your education to meet qualification requirements:

    Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education.

    Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.

  • How to Apply

    Please read the entire announcement and all the instructions before you begin an application. To apply for this position, you must complete the initial online application, to include the initial online questionnaire and submission of the required documentation specified in the How to Apply and Required Documents section. The complete application package must be submitted by 11:59 PM (ET) on the closing date of the announcement to receive consideration. To preview the application questionnaire, click https://apply.usastaffing.gov/ViewQuestionnaire/12499635. The application process is as follows:

    • To begin, click Apply Online to create a USA JOBS account or log in to your existing account. Follow the prompts to select your USA JOBS resume and/or other supporting documents.
    • Answer the questions presented in the application and attach all necessary supporting documentation.
    • Click the Submit Application button prior to 11:59 PM (ET) on the announcement closing date, 08/09/2024. NOTE: It is your responsibility to ensure your responses and appropriate documentation is submitted prior to the closing date.
    • If you are required to complete any USA Hire Assessments, you will be notified after submitting your application. The notification will be provided in your application submission screen and via email. The notification will include your unique assessment access link to the USA Hire system and the completion deadline. Additionally, in USAJOBS you can click "Track this application" to return to your assessment completion notice.
    • Access USA Hire using your unique assessment link. Access is granted through your USAJOBS login credentials.
    • Review all instructions prior to beginning your assessments. You will have the opportunity to request a testing accommodation before beginning the assessments should you have a disability covered under the Rehabilitation Act of 1973 as amended.
    • Set aside at least 3 hours to take the USA Hire Assessments; however, most applicants complete the assessments in less time. If you need to stop the assessments and continue later, you can re-use your unique assessment link. NOTE: Your responses to the USA Hire Assessments will be reused for one year (in most cases) from the date you complete an assessment. If future applications you submit require completion of the same assessments, your responses will be automatically reused.
    For more general information, system requirements, reasonable accommodation information, and to request assistance regarding the USA Hire Assessments, review the following resources:
    https://help.usastaffing.gov/Apply/index.php?title=USA_Hire_Assessments
    To update your application, including supporting documentation: During the announcement open period, return to your USAJOBS account, find your application record, and click Edit my application. This option will no longer be available once the announcement has closed.
    To view the announcement status or your application status: https://www.usajobs.gov/Help/howto/application/status/.
    Your application status page is where you can view your application status, USA Hire assessment completion status, and review your notifications sent by the hiring agency regarding your application.
    Reasonable Accommodation (RA) 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 a 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 a 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
    Placement Policy: The posting of this announcement does not obligate management to fill a vacancy or vacancies by promotion. The position may be filled by reassignment, change to lower grade, transfer, appointment, or reinstatement. Management may use any one or any combination of these methods to fill the position.
    It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.

    Agency contact information

    Brianna Turner
    Phone
    708-904-8377
    Email
    Brianna.Turner@va.gov
    Address
    Captain James A Lovell Federal Health Care Center
    3001 Green Bay Road
    North Chicago, IL 60064
    US

    Next steps

    Once your online application is submitted you will receive a confirmation notification by email. After we receive application packages (including all required assessments and documents) and the vacancy announcement closes, we will review applications to ensure qualification and eligibility requirements are met. After the review is complete, a referral certificate(s) is issued, and applicants will be notified of their status by email. Referred applicants will be notified as such and may be contacted directly by the hiring office for an interview. All referred applicants receive a final notification once a selection decision has been made.
    If you are referred for consideration, you may be asked to submit additional job related information, which may include, but not limited to; responses to the knowledge, skills and abilities; completion of a work sample, and/or contact for an interview. Your resume and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect your rating or consideration for employment.
    The Department of Veterans Affairs performs pre-employment reference checks as an assessment method used in the hiring process to verify information provided by a candidate (e.g., on resume or during interview or hiring process); gain additional knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position.
    You may check the status of your application at any time by logging into your USA Jobs account and clicking on Applications. Information regarding your application status can be found in the USAJobs Help Center.

  • Fair and Transparent

    The Federal hiring process is set up to be fair and transparent. Please read the following guidance.

    • Criminal history inquiries
    • Equal Employment Opportunity (EEO) Policy
    • Financial suitability
    • New employee probationary period
    • Privacy Act
    • Reasonable accommodation policy
    • Selective Service
    • Signature and false statements
    • Social security number request

Required Documents

To apply for this position, you must provide a complete Application Package which includes:

  • Resume
Other accepted documents:
  • Cover Letter
  • DD-214/ Statement of Service
  • Disability Letter (Schedule A)
  • Disability Letter (VA)
  • License
  • Other (1)
  • PCS Orders
  • Performance Appraisal
  • Professional Certification
  • Resume
  • Separation Notice (RIF)
  • SF-15
  • SF-50/ Notification of Personnel Action
  • Transcript
Please review the above list(s) to ensure you have included all necessary documents required for your application. Not every applicant will require the same documents, therefore it is the applicants responsibility to ensure that their application package includes all necessary documents to determine qualifications and eligibility for appointment, such as a copy of your SF-50, transcript, ICTAP/CTAP documentation (for displaced Federal employees). Applicants will be deemed ineligible if supporting documentation is not submitted. You will not be contacted for additional information.
Veterans' Preference: Since the Direct-Hire Recruitment Authority is being used, traditional Veterans' Preference rules do not apply. Qualified veterans will, however, be given full consideration for this position.
It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.
NOTE: Participation in the seasonal influenza program is a condition of employment and a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). It is a requirement that all HCP to receive annual seasonal influenza vaccination or obtain an exemption for medical or religious reasons. Wearing a face mask is required when an exemption to the influenza vaccination has been granted. HCP in violation of this directive may face disciplinary action up to and including removal from federal service. HCP are individuals who, during the influenza season, work in VHA locations or who come into contact with VA patients or other HCP as part of their duties. VHA locations include, but are not limited to, VA hospitals and associated clinics, community living centers (CLCs), community-based outpatient clinics (CBOCs), domiciliary units, Vet centers and VA-leased medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation, full- and part-time employees, intermittent employees, fee basis employees, VA contractors, researchers, volunteers and health professions trainees (HPTs) who are expected to perform any or all of their work at these facilities. HPTs may be paid or unpaid and include residents, interns, fellows and students. HCP also includes VHA personnel providing home-based care to Veterans and drivers and other personnel whose duties put them in contact with patients outside VA medical facilities.
Special Employment Consideration: VA encourages persons with disabilities to apply, including those eligible for hiring under 5 CFR 213.3102(u), Schedule A, Appointment of persons with disabilities [i.e., intellectual disabilities, severe physical disabilities, or psychiatric disabilities], and/or Disabled veterans with a compensable service-connected disability of 30% or more. Contact the Agency Contact for information on how to apply under this appointment authority via the Selective Placement Coordinator.

If you are relying on your education to meet qualification requirements:

Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education.

Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.

Help

This job is open to

  • The public

    U.S. Citizens, Nationals or those who owe allegiance to the U.S.

Clarification from the agency

ALL US CITIZENS DIRECT HIRE AUTHORITY: This position is being filled using Direct-Hire Authority (5 CFR 337.205) for this occupation.

Job Summary

JOB TYPE

Full Time

SALARY

$55k-73k (estimate)

POST DATE

08/03/2024

EXPIRATION DATE

10/01/2024

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If you are interested in becoming a Health System Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Health System Specialist for your reference.

Step 1: Understand the job description and responsibilities of an Accountant.

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Health system specialists are administrators who coordinate the delivery of healthcare programs and services.

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Monitors compliance with federal, state, and local regulatory requirements.

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Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.

Career tips from people on Health System Specialist jobs

Hospitals, clinics, and other care facilities can employ health system specialists to support their work, and these allied health professionals can also work for administration programs.

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Ongoing evaluation of the quality of care and delivery methods can also be among the responsibilities of a health system specialist.

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Research regionally accepted health system certifications and pass the exams.

03/30/2022: Manchester, NH

Working as a public health specialist can be very challenging and rewarding.

03/02/2022: Scranton, PA

Pursue a health specialist certification.

04/07/2022: Daytona Beach, FL

Step 3: View the best colleges and universities for Health System Specialist.

Butler University
Carroll College
Cooper Union
High Point University
Princeton University
Providence College
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