Health System Specialist (Credentialing & Privileging)

Employer
USAJobs
Location
Washington, D.C
Posted
Feb 21, 2021
Closes
Feb 27, 2021
Function
Administrative
Hours
Full Time
Duties

Summary

The Health System Specialist (Credentialing and Privileging) (C&P) is responsible for providing administrative and technical direction and support to Credentialing and Privileging Operations, VA Medical Center, Washington, DC.
Learn more about this agency

Responsibilities

Duties of the Health System Specialist (C&P) include and are not limited to:

Ensures 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 or external auditors and reviewers as appropriate.

Assists the C&P Manager/Analyst in developing short- and long-term goals necessary to accomplish the mission of the C&P program. Assists in identifying the resources necessary for accomplishing the mission and function of the credentials and privileging program.

Serves as SME in the field of credentials and clinical privileging.

Assists C&P Manager/Analyst in drafting local credentialing processes and Medical Staff Bylaws in compliance with all applicable regulations.

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. Upon identification of a problem, researches reference materials, regulations, and standards to identify appropriate action necessary to correct the problem. Issues of a serious nature are elevated to the supervisor for guidance.

Prepares agendas for credentials related meetings, ensures those involved are notified of expectations, and ensures appropriate paperwork is accomplished completely and accurately prepared for committee action. Has responsibility to ensure LIPs credentials files (2-part folders) are prepared properly, maintained appropriately, and are accurate and current. Documents details of privileging actions, both routine and adverse, in detail with accuracy necessary for defending appeals to higher authority. Conducts audits of provider time-limited credentials, such as licenses and provider certifications and ensures that detailed information is documented on provider exit review forms, privileging documents, FPPE and OPPE tracking system, credentialing program training

Assures 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.

Communicates with LIPs to assure timely completion of applications and VetPro requirements. Provides oversight to application process; analyzes exceptions and deviations in expected application process; determines course of action and makes recommendations.

Determines processes for coordination of incoming data and documents from a variety of sources. Documents include, but are not limited to, VA applications for employment, primary source verifications of education and training, peer recommendations, licensure, DEA license, board certification, NPDB CQ reports and personal history, and malpractice claims, FPPE, OPPE, etc. Reviews documents and applications for omissions and inconsistencies and assures data entry is complete and accurate to meet VHA policy and regulation, and TJC standards. Reviews documents received and determines course of action based on information provided within documents. Contacts provider for omissions and/or inconsistencies in information; initiates primary source verification of credentials.

Ensures accurate provider data is entered into and maintained in the VetPro computer program. Ensures 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, certifications, adverse licensure or privileging actions, initial and renewal of privileges which may affect the status of privileges granted for medical practice. Informs C&P Manager/Analyst of trends identified, audit results and identified problems that may affect a provider's privilege status.

*All other duties as assigned and outlined in position description.

Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level.

Work Schedule: Monday through Friday, 8:00 AM to 4:30 PM
Telework: Available
Virtual: This is not a virtual position.
Position Description/PD#: Health System Specialist (Credentialing & Privileging)/PD99876A
Financial Disclosure Report: Not required

Travel Required

Not required

Supervisory status
No

Promotion Potential
9

Requirements

Conditions of Employment

  • You must be a U.S. Citizen to apply for this job
  • Designated and/or random drug testing may be required
  • 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


Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 02/26/2021.

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-7 position you must have served 52 weeks at the GS-5. 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.

You may qualify based on your experience and/or education as described below:
GS-7
  • Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade (GS-5) in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: progressively responsible analytical or administrative, or clinical management; supervisory experience in a healthcare field; work in an operating healthcare facility or a higher organizational echelon with advisory or directional authority with work involving close working relationship with facility managers and/or analysis coordination; etc.; OR,
  • Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have earned 1 full year of graduate level education with major study in hospital administration, public health administration, or related field such as business or public administration OR I have received Superior Academic Achievement (*S.A.A.) ; OR,
  • Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond your undergraduate level education. To calculate , first identify the percentage of required education you have earned. Then identify the percentage of required experience you possess. Add the two percentages. The total percentage must equal at least 100 percent. One year of full-time academic graduate study is defined as 18 semester hours or 27 quarter hours.
S.A.A. is based on (1) class standing, (2) grade-point average, or (3) honor society membership.
  • Class standing -- Applicants must be in the upper third of the graduating class in the college, university, or major subdivision, such as the College of Liberal Arts or the School of Business Administration, based on completed courses.
  • Grade-point average (G.P.A.) -- Applicants must have a grade-point average of: 3.0 or higher out of a possible 4.0 ("B" or better) as recorded on their official transcript, or as computed based on 4 years of education, or as computed based on courses completed during the final 2 years of the curriculum; or
  • 3.5 or higher out of a possible 4.0 ("B+" or better) based on the average of the required courses completed in the major field or the required courses in the major field completed during the final 2 years of the curriculum
  • Election to membership in a national scholastic honor society -- Applicants can be considered eligible based on membership in one of the national scholastic honor societies listed below. These honor societies are listed by the Association of College Honor Societies (external link) . Agencies considering eligibility based on any society not included in the following list must ensure that the honor society meets the minimum requirements of the Association of College Honor Societies. Membership in a freshman honor society cannot be used to meet the requirements of this provision.


  • 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 in the organization. Examples of specialized experience would typically include, but are not limited to: progressively responsible analytical or administrative, or clinical management; supervisory experience in a healthcare field; work in an operating healthcare facility or a higher organizational echelon with advisory or directional authority with work involving close working relationship with facility managers and/or analysis coordination; etc.; OR,
    • Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have earned a master's or equivalent graduate degree in hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration; OR completion of 2 full years of progressively higher level graduate education leading to such a degree (with major or like courses as those previously listed); OR,
    • Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond your first 27 semester hours. To calculate , first identify the percentage of required education you have earned. Then identify the percentage of required experience you possess. Add the two percentages. The total percentage must equal at least 100 percent. One year of full-time academic graduate study is defined as 18 semester hours or 27 quarter hours.

    You will be rated on the following Competencies for this position:
    • Analytical Reasoning
    • Communications
    • Computer Skills
    • Planning and Evaluating


    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/ .

    Education

    There is no educational substitution at this grade level.

    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

    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.

    Receiving Service Credit or Earning Annual (Vacation) Leave: Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. VA may offer newly-appointed Federal employee's credit for their job-related non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed.

    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/ .

    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.

    This job opportunity announcement may be used to fill additional vacancies.

    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.

    For more information on the "Who may apply" eligibility requirements, please refer to the OHRM Status Candidates and Other Candidate Definitions document.

    If you are unable to apply online view the following link for information regarding an Alternate Application .

    How You Will Be Evaluated

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

    IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE.

    Narrative responses are not required at this time. 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.

    Background checks and security clearance

    Security clearance
    Other

    Drug test required
    No

    Position sensitivity and risk
    Non-sensitive (NS)/Low Risk

    Trust determination process
    Suitability/Fitness

    Required Documents

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


    The following documents are accepted, and may be required if applicable to your eligibility and/or qualifications for this position. Please use this checklist to make sure you have included other documents required for your application, such as a copy of your transcript (if using education to qualify), SF-50's (current/former Federal employees), documentation to support Veterans Preference claims, or ICTAP/CTAP documentation (for displaced Federal employees). You will not be contacted for additional information.
    • Cover Letter
    • DD-214/ Statement of Service
    • Disability Letter (Schedule A)
    • Disability Letter (VA)
    • Other (1)
    • Performance Appraisal
    • Resume
    • Separation Notice (RIF)
    • SF-15
    • SF-50/ Notification of Personnel Action
    • Transcript


    SF-50, Notification of Personnel Action (if applicable for Time in Grade and/or Eligibility):
    • Most recent SF-50 if you are a current or former Federal employee
    • An SF-50 showing 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
    • Award 50's do not provide sufficient information and will not be accepted for the purpose of verifying time-in-grade.
    • Examples of appropriate SF-50's include:
      • Within grade increases at the highest grade held; or
      • Promotions with an effective date more than one year old; or
      • SF-50's at the highest grade held with an effective date more than one year old.
    Veterans' Preference: When applying for Federal Jobs, eligible Veterans should claim preference for 5pt (TP), 10pt (CP/CPS/XP), or for Sole Survivor Preference (SSP) in the questionnaire. You must provide a legible copy of your DD214(s) which shows dates and character of service (honorable, general, etc.). If you are currently serving on active duty and expect to be released or discharged within 120 days you must submit documentation related to your active duty service which reflects the dates of service, character of service (honorable, general, etc.), and dates of impending separation. Additionally, disabled veterans and others eligible for 10-point preference (such as widows or mothers of eligible Veterans) must also submit an SF-15 "Application for 10 Point Veteran Preference" with required proof as stated on the form. Documentation is required to award preference. For more information on Veterans' Preference, please visit http://www.fedshirevets.gov/job/vetpref/index.aspx .

    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.

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