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Are you looking for a Medical Management Specialist? We suggest you consider a direct vacancy at Veterans Health Administration in Hines. The page displays the terms, salary level, and employer contacts Veterans Health Administration person

Job opening: Medical Management Specialist

Salary: $109 732 - 142 650 per year
City: Hines
Published at: Aug 15 2023
Employment Type: Full-time
The Integrity & Compliance Officer contributes to the fulfillment of the organization's mission and vision by planning, designing, implementing, and maintaining system-wide compliance programs, policies, and procedures. The Integrity & Compliance Officer reports directly to the Corporate Compliance Office and provides guidance and counsel on incorporating compliance related activities into the operations of a large, complex multi-mission facility.

Duties

Duties include but are not limited to: - Developing, recommending and implementing compliance and integrity program goals for operational units within the local health care system. - Developing detailed plans, tasks, milestone dates and schedules to ensure proper sequencing of events and tracking of processes and costs throughout the life cycle of the programs/projects. - Participating in regular information planning sessions, maintain productive interaction with staff, report on the status and progress of work accomplished to date, and monitor work in progress. - Exercising oversight of implementation of the Integrity and Compliance program within the local health care system to ensure it is effective. - Implementing national Compliance and Integrity controls, solutions, and programs at the local health care system. - Developing and implementing internal controls and solutions, in partnership with risk owners, to manage and mitigate key risks that may adversely impact local health care system objectives, compliance with regulations, or overall reputation within the local, VISN, or national landscape of the agency health care system. - Establishing and maintaining the "tone at the top" within the local health care system for Integrity and Compliance. - Providing regular communications to local health care system staff on the importance of Integrity and Compliance. - Drafting guidance and direction regarding program management and reporting. - Performing local health care system-wide reviews of internal controls over prioritized risk areas and determine adequacy in preventing compliance failures. - Participating in meetings with internal staff and representative operational units within the local health care system to determine compliance program status, major milestones, and coordination of each to detect in advance potential slippage or increased costs. - Understanding local strategy, local needs, and risks of the local health care system. - Analyzing and prioritizing local risks by working closely with senior management to develop a proactive strategy to mitigate compliance risks. - Oversees the education and training process for the facility's employees regarding compliance-related activities. - Monitors questions, issues and reports of possible non-compliance reported through established mechanisms. - Reports on a regular basis to the Corporate Compliance Officer and the compliance committee on the progress of implementation and assisting these entities in establishing methods to improve quality of services and to reduce the facility's vulnerability to fraud, abuse, and waste. - Coordinates internal and external compliance reviews. - Initiates investigation, when appropriate, of any issues of non-compliance as well as the implementation of appropriate corrective action plans. - Participates in the VISN 12 Integrity & Compliance Committee to share best practices with other VISN facilities. - Chair/Co-Chair the Facility Compliance Committee. - Performs other related duties as assigned. Work Schedule: 730-0400P Telework: AD-HOC Telework may be available Virtual: This is not a virtual position. Position Description/PD#: Medical Management Specialist/PD000000 Relocation/Recruitment Incentives: Not Authorized Financial Disclosure Report: Not required

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 08/21/2023. 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 GS13 position you must have served 52 weeks at the GS12. 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 as described below: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS12 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Examples of specialized experience would typically include, but are not limited to: communicating timely with senior executives on any urgent and significant compliance or business integrity issues.; establishing program objectives and units of measure for determining when objectives have/have not been met and developing and implementing internal controls and solutions to manage and mitigate key risks that may adversely impact local health care system You will be rated on the following Competencies for this position: Compliance Internal Controls Internal Controls/Integrity Administration and Management Analysis and Problem Solving Communications Organizational Performance Analysis 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: Physical exertion is limited to walking, climbing, stooping, bending, reaching, and occasionally driving. Sitting and manual dexterity are required to keyboard for extended periods of time in the execution of administrative duties. 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.



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.

Contacts

  • Address Edward Hines Junior Hospital 5000 South 5th Avenue Hines, IL 60141 US
  • Name: Vanessa Houliston
  • Phone: 725-210-2766
  • Email: [email protected]

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