Health System Specialist - Credentialing & Privileging Specialist

Employer
USAJobs
Location
Baltimore, Maryland
Posted
Dec 01, 2022
Closes
Dec 08, 2022
Function
Administrative
Hours
Full Time
Duties

Major duties include, but are not limited to:
  • Provides administrative and technical direction and support to the Credentialing & Privileging office.
  • Ensures C&P compliance with VHA policies, directives, memos, and notices of The Joint Commission (TJC) standards, recommendations by the Office of Inspector General (OIG) and Government Accountability Office (GAO) and other internal and external auditors and reviewers as appropriate.
  • Collects relevant C&P data and make informed C&P decision to ensure qualified health care professionals are providing appropriate patient care in appropriate settings.
  • Assists the C&P Manager/Analyst in developing short- and long-term goals necessary to accomplish the mission of the VHA C&P program.
  • Identifies the resources necessary for accomplishing the mission and function of the C&P program.
  • Drafts local credentialing processes and Medical By-laws, agendas, and meeting minutes.
  • Serves as the subject matter expert (SME) in the field of credentials and clinical privileges, to LIPs and service chiefs regarding routine and complex matters related to C&P including provider competence for the OPPE and FPPE process.
  • Keeps leadership and appropriate administrative staff informed of program changes, new regulatory requirements, and policies and procedures pertaining to the VHA C&P process.
  • Receives and reviews correspondence and communications for the C& P function and determines which items require immediate attention and which are confidential in nature.
  • Receives and reviews VetPro reports detecting problem areas requiring further investigation.
  • Research reference materials, regulations, and standards to identify appropriate action necessary to correct the problem.
  • Ensures and monitors accurate provider C&P data is entered into and maintained in the VetPro computer program, current information is present on providers relative to state licensure, Drug Enforcement organization (DEA) license, National Practitioner Data Bank (NPDB) continuous query (CQ) enrollments and renewals, Federation of State Medical Boards (FSMB), documentation of professional education, specialty medical training, adverse licensure or privileging actions, initial and renewal of privileges which may affect the status of privileges grated for medical practice.
  • Informs Managers on audit results and identified problems that may affect a provider's privileges.
  • Ensures application package and other documents meet technical requirements based on specialty of the provider.
  • Conducts final appointment into the VetPro database, after thoroughly researching, analyzing and validating all data, information, documents and signature authorities.
  • Ensures suspense's are met in the time sensitive actions for privileges modification, biennial renewals, temporary limitations or suspensions, and any other time-limited privileging action.
Work Schedule: Monday - Friday 8:00am - 4:30pm
Telework: Not Authorized
Virtual: This is not a virtual position.
Position Description/PD#: Health System Specialist - Credentialing & Privileging Specialist/PD99876-A
Relocation/Recruitment Incentives: Not Authorized
Permanent Change of Station (PCS): Not Authorized
Financial Disclosure Report: Not required

Requirements

Conditions of Employment


  • You must be a U.S. Citizen to apply for this job
  • 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, 12/09/2022.

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-9 position you must have served 52 weeks at the GS-7. 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.

Individual Occupational Requirement (IOR): You must meet the following Individual Occupational Requirement:
  • Undergraduate and Graduate Education with a major study in hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. 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.
  • 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:

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

GS-9 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-7 in the normal line of progression for the occupation. Examples of specialized experience would typically include, but are not limited to: experience gathering, analyzing documents and tracking program data from beginning to end; meeting compliance measures; experience in data collection and reporting outcomes; working experience with medical terminology, and medical specialties; experience in the basic principles, provision and practices of credentialing, privileging, and medical staff processes. NOTE: This experience must be documented on your resume to receive credit. OR,
Education:
Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have one full year of graduate level education or superior academic achievement. OR,
Combination:
Applicants may also combine education and experience to qualify at this level. You must have a combination of successfully completed post-high school education and experience may be used to meet total qualification requirements for the grade levels specified in the table and may be computed by first determining the applicant's total qualifying experience as a percentage of the experience required for the grade level; then determining the applicant's education as a percentage of the education required for the grade level. You will be rated on the following Competencies for this position:
  • Technical Competence
  • Analytical Reasoning
  • Customer Service
  • Compliance
  • Planning and Evaluating
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: This factor covers the requirements and physical demands placed on the employee by the work assignment.
The work is sedentary, although some slight physical effort may be required. Level 8-1 is appropriate here.

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: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html .

Additional information

The 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.

Pursuant to VHA Directive 1193.01, VHA health care personnel (HCP) are required to be fully vaccinated against COVID-19 subject to such accommodations as required by law (i.e., medical, religious or pregnancy). VHA HCPs do not include remote workers who only infrequently enter VHA locations. If selected, you will be required to be fully vaccinated against COVID-19 and submit documentation of proof of vaccination before your start date. The agency will provide additional information regarding what information or documentation will be needed and how you can request a legally required accommodation from this requirement using the reasonable accommodation process.

If you are unable to apply online or need to fax a document you do not have in electronic form, view the following link for information regarding an Alternate Application .

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