Health System Specialist(Credentialing & Privileging Specialist)

The Health System Specialist -Credentialing and Privileging Specialist is assigned to the Medical Staff Office, which is under the Chief of Staff at a VA Medical Center (VAMC) and is responsible for providing administrative and technical direction and support to the credentialing and privileging (C&P) operations. The C&P Specialist is aligned to and supervised by the C&P Manager.

Qualifications:

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 01/17/2024.

Individual Occupational Requirement (IOR / Series 0671 / GS-09): This position requires education or experience that must have been related to the work of the position for which the application is made. Applicants must meet one of the following:
Undergraduate and Graduate Education: Major study-hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration (Transcript Required).

OR,

Specialized Experience: Progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care field. This work may have been performed in an operating health care facility or a higher organizational echelon with advisory or directional authority over such facilities. Work must have involved a close working relationship with facility managers and analysis and/or coordination of administrative, clinical, or other service activities, and provided knowledge of the following:

• Missions, organizations, programs, and requirements of health care delivery systems;
• Regulations and standards of various regulatory and credentialing groups; and
• Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement.

OR,

Special Provision for In-service Placement: Successful completion of an agency-sponsored on-the-job training program may be substituted for qualifying experience, provided it included a formal individualized training plan. Such a training program must have been conducted in an operating health care system and included:

• Assignments providing a knowledge of basic health system administration philosophies, practices, and procedures, and basic government administrative policies and requirements;
• Practical assignments providing an opportunity to apply health system administration skills and principles (as the individual progresses, work assignments must be characteristic of the grade level to which he or she is assigned); and
• Oversight by an experienced health system administrator with periodic evaluation of the individual's progress and appropriate adjustment of the training program.

In addition to meeting the above IOR requirement, applicant must also meet the following grade requirement:

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-09 position you must have served 52 weeks at the GS-07. 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.

You may qualify based on your experience and/or education as described below:

Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-07 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to:

• Ability to perform a detailed analysis of all information on an ongoing basis to confirm the medical staff applicant/member is competent to perform the privileges s/he is requesting (e.g., researching training discrepancies, malpractice claims, prior licensure actions and other issues identified via this process).
• Knowledge of medical terminology, medical specialties, and core privileges and procedures to assure competence/appropriateness of credentials and privileging requested
• Ability to communicate technical information to a diverse group of individuals
• Comprehensive knowledge of VetPro policies
• Skill in using software applications such as word processing and data bases and internet databases

OR,

Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a master's or equivalent graduate degree or2 full years of progressively higher-level graduate education leading to such a degree or LL.B. or J.D., if related

OR,

Combination: Applicants may also combine education and experience to qualify at this level. You must have a combination of specialized experience and education beyond the first full year of graduate education.

Note: IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Verbiage displayed on your resume or application must contain your own words. You may refer to the specialized experience located within the vacancy announcement, to assist with describing work experiences; however, resumes or applications received that copied verbatim from the announcement will be evaluated and may be reviewed as falsifying your experience or application.

You will be rated on the following Competencies for this position:

• Communications
• Compliance
• Quality Assurance
• 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 work is mostly sedentary. Occasionally, light physical effort may be required, such as that involved with walking, stair climbing, and carrying of light office items.

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/.

Responsibilities:

Major duties include, but are not limited to:

• Performing as the subject matter expert (SME) to Licensed Independent Providers (LIPs) and Service Chiefs regarding routine and complex matters related to C&P.
• Assisting the C&P Manager/Analyst in developing short- and long-term goals necessary to accomplish the mission of the C&P program.
• Assisting the C&P Manager/Analyst in drafting local credentialing processes and Medical Staff Bylaws in compliance with all applicable regulations.
• Receiving and reviewing VetPro reports detecting problem areas requiring further investigation.
• Informing the C&P Manager/Analyst of trends identified, audit results and identified problems that may affect a provider's privilege status.
• Providing guidance and instruction to hospital staff in completing the required documentation of establishing privileges for LIPs.
• Assuring application packages and other documents meet technical requirements per specialty of provider and assures application folder and database account (VetPro or other internal databases and spreadsheets) meet technical requirements.
• Serving as technical advisor to the Executive Committee of the Medical Staff (ECMS) and if applicable the Credentials Committee.
• Developing and providing routine and special reports as requested by the C&P Manager/Analyst.
• Establishing and maintains a variety of files and records pertaining to the C&P process.

Work Schedule: Monday- Friday 8:00am-4:30pm
Telework: Ad-Hoc
Virtual: This is not a virtual position.
Position Description/PD#: Health System Specialist(Credentialing & Privileging Specialist)/PD99876-S
Functional Statement #: PD99876-S
Relocation/Recruitment Incentives: Not Authorized
Financial Disclosure Report: Not required