SUMMARY

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.

INDIVIDUAL OCCUPATIONAL REQUIREMENT (IOR): An IOR is a basic requirement that must be met in order to qualify for entry into this job series, and it is something that can’t be waived. The education must be accredited by an accrediting body recognized by the U.S. Department of Education at the time the degree was obtained. To qualify for the GS 0671 occupational series, applicants MUST possess one of the following:

• UNDERGRADUATE AND GRADUATE EDUCATION: undergraduate or graduate education in a major field of study hospital administration, public health administration, or related fields, such as business or public administration, with course work in health care administration. (A transcript must be submitted with your application if you are basing your qualifications on education). OR,
• SPECIALIZED EXPERIENCE: specialized experience that is progressively responsible for analytical or administrative, or clinical management, or supervisory experience in the health care field performed in an operating health care facility or a higher organizational echelon with advisory or directional authority over such facilities with close working relationships with facility managers and analysis/coordination of administrative, clinical, or other service activities which provided knowledge in the following areas: 1) Missions, organizations, programs, and requirements of health care delivery systems; 2) Regulations and standards of various regulatory and credentialing groups; and 3) Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement. OR,
• SPECIAL PROVISION FOR INSERVICE PLACEMENT: Completion of an agency-sponsored on-the-job training program, which included a formal individualized training plan. The training program should have been performed in an operating health care system and included: 1) Assignments providing a knowledge of basic health system administration philosophies, practices, and procedures, and basic government administrative policies and requirements; 2) 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 3) 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 IOR, you may qualify based on your specialized experience as described below:

TO QUALIFY FOR THIS POSITION AT THE GS-9 LEVEL, YOU MUST MEET ONE OF THE FOLLOWING:

Specialized Experience: You must have at least one (1) full year of specialized experience, equivalent to the next lower grade level (GS-7) in Federal Service, that equipped you with the particular knowledge, skills, and abilities to successfully perform the duties of a Health System Specialist - Credentialing and Privileging, and includes performing duties associated with healthcare credentialing and privileging. Qualifying specialized experience is defined as 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: (1) Missions, organizations, programs, and requirements of health care delivery systems; (2) Regulations and standards of various regulatory and credentialing groups; and (3) Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement. .
~OR~
Education: Successful completion of a master’s or equivalent graduate degree, successfully completed two (2) full years of progressively higher level graduate education leading to such a degree, LL.B or J.D. if related. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work of this position (i.e., hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration). NOTE: Copies of transcripts must be submitted with your application materials. Education cannot be credited without documentation.
~OR~
Combination: Combinations of successfully completed graduate level education (beyond the first year) and specialized experience, as described above, to meet the total requirements. The education portion must include graduate courses that demonstrate the knowledge, skills, and abilities necessary to do to the work of this position (i.e. hospital administration, public health administration, or related fields such as course work in health care administration). NOTE: Copies of transcripts must be submitted with your application materials. Education cannot be credited without documentation.
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.

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.

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.
• 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.
• 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 reports detecting problem areas requiring further investigation and which are confidential in nature.
• 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 maintaining a variety of files and records pertaining to the C&P process.
• Performs other duties as assigned.

Work Schedule: Monday through Friday 7:30am - 4:00pm
Position Description Title/PD#: Health System Specialist - Credentialing and Privileging/PD99876S
Physical Requirements and Work Environment: 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. The work is performed in an office setting which require normal safety precautions typical for offices and meeting rooms. The work area is adequately lighted, heated, and ventilated.