This position is located in the Office of Operational Support, Albuquerque Area Indian Health Service. The purpose of this position is to provide consultative services regarding the day-to-day operations of the Purchased & Referred Care (PRC) programs for the Albuquerque Area and provides technical consultation to ten service unit PRC Department Managers. The incumbent in this position reports to the Executive Officer, Office of Operational Support.

Duties

THIS POSITION IS BEING RE-ADVERTISED TO SOLICIT ADDITIONAL APPLICATIONS. APPLICANTS WHO APPLIED PREVIOUSLY NEED NOT REAPPLY UNLESS SUBMITTING UPDATED AND/OR MISSING INFORMATION. Interpreting federal Purchased/Referred Care (PRC) regulatory policies and procedures, reviewing best practices, proposing procedural enhancements and coordinating process improvement plans and projects. Responsible for the planning, conducting, coordinating and managing PRC program review activities throughout the Area and producing annual reports and summaries regarding the Area's level of compliance with PRC federal regulatory, financial and programmatic requirements. Develop statistical data from various sources, i.e., automated financial system, to review, approve and recommend changes to PRC operation/budgets/ Review denial letters to ensure decision was proper and in accordance with Agency policy and procedures. Report on cases covered under the Catastrophic Health Emergency Fund (CHEF) to ensure proper compliance with P.L. 101-713 Section 202.

Requirements

Qualifications

To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying. 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; religious; spiritual; community; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week. BASIC REQUIREMENTS: Individual Occupational Requirements 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. In addition to the Basic Requirements, you must also meet the Minimum Qualifications stated below. MINIMUM QUALIFICATIONS: GS-09 1 year of specialized experience that equipped me with the particular knowledge, skills and abilities to successfully perform the duties of this position. This experience is related to the work of the position and equivalent to at least the GS-07 level in the Federal service as described in the vacancy announcement. Examples include: performs duties at a trainee level, provide assistance to supervisor and staff in monitoring expenditures of services provided to beneficiaries; assist with explaining eligibility for services to beneficiaries; drafts correspondence and reports for manager and senior staff review; work with automated financial reporting systems;OR Completed a master's or equivalent graduate degree that included 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 Completed two full years of progressively higher level graduate education leading to such a degree that included major study -- hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration; or a LL.B or J.D., if related; OR Possess a combination of education and specialized experience that when combined fully meet the minimum qualifications for this position. The total percentage equals at least 100 percent to qualify for this GS-09 grade level. GS-11 1 year of specialized experience that equipped me with the particular knowledge, skills and abilities to successfully perform the duties of this position. This experience is related to the work of the position and equivalent to at least the GS-09 level in the Federal service as described in the vacancy announcement. Examples include: provide technical support and assistance to program staff and facility staff on matters involving oversight and management of various services; perform high cost case management of expenditures to determine cases that may include catastrophic illnesses; advise and educate beneficiaries on eligibility of services; assist with monitoring of fund control and appropriate use of dollars spent on allowed services. OR Completed a Ph.D. or equivalent doctoral degree or Completed 3 full years of progressively higher level graduate education leading to such a degree that includes a major study - hospital administration, public health administration, or related fields such as business or public administration course work in health care administration or LL.M., if related; OR Possess a combination of education and specialized experience that when combined fully meet the minimum qualifications for this position. The total percentage equals at least 100 percent to qualify for this GS-11 grade level. GS-12 1 year of specialized experience that equipped me with the particular knowledge, skills and abilities to successfully perform the duties of this position. This experience is related to the work of the position and equivalent to at least the GS-11 level in the Federal service as described in the vacancy announcement. Examples include: follows established policies and procedures of a contract health care and alternate resource program, determines if program is functioning efficient and effectively to meet established requirements; conducts reviews to monitor and evaluate private contractor and facility program in the areas of health care, finance, contracting and administration which include coordination of benefits, medical service contracts and agreements; provide written findings and recommendations of review; review and resolve complaints and problems from customers; monitors spending plans and financial transactions to ensure compliance with established guidelines. Time In Grade Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP). You must meet all qualification requirements within 30 days of the closing date of the announcement.

Education

This position has an education requirement. You are strongly encouraged to submit a copy of your transcripts or a list of your courses including titles, credit hours completed, and grades. Unofficial transcripts will be accepted in the application package. Official transcripts will be required from all selectees prior to receiving an official offer.

Only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education may be credited. Applicants can verify accreditation at the following website: https://www.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.

Contacts

• Address Albuquerque Area Indian Health Service 4101 Indian School Rd NE, Suite 225 Albuquerque, NM 87110 US
• Name: Carolyn Chavez
• Phone: (505) 256-6824
• Email: [email protected]