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Job opening: Health System Specialist - Credentialing & Privileging Manager

Salary: $85 582 - 111 257 per year
Published at: Aug 21 2023
Employment Type: Full-time
The Health Systems Specialist (organizational title is Credentialing and Privileging Manager) is assigned to the Medical Staff Office, which is under the Chief of Staff (COS) . Oversees all functions related to healthcare providers' professional credentials supporting all divisions of the VAMC in accordance with VHA Credentialing and Privileging (C&P), Directives, VA Handbooks, Policies, Memos, and Notices; The Joint Commission (TJC) Standards and State and Federal Regulations.

Duties

Duties: Senior Program Advisor: Provides consulting and guidance to local leadership and Credentialing and Privileging (C&P) employees on all matters pertaining to the program, Determines appropriate actions, including those resulting from VISN and local reviews, initial and re-credentialing processes, including, primary source verifications, reporting and data trends, identify issues requiring further review and electronic database and clinical privilege maintenance, documents and composes minutes, privileging requests and/or actions, malpractice payments, tort claims and adverse actions, Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE) review and completion timeframes. Serves as primary consultant, analyzes program audit results, interprets facility quarterly report card data, researches provider credentialing requirements, identifies potential privileging issues, drafts Medical Staff Bylaws, updates and revisions, explains new regulatory requirements and VHA requirements, procedures and processes, contributes to development of local policies, prepares Federal and State medical boards reports, tracks state licensing board reporting, manages Vetpro access levels and training, assists with Joint Commission Surveys and Office of Inspector General and Government Accountability office reviews. Demonstrates expertise in utilization of the VetPro credentialing system. Ensure timely reporting to th NPDB and SLB. Partners with contracting office to ensure contracts are appropriate. Quality Assurance: Ensures quality assurance of the facility C&P program. Apply organizational and system wide strategies for quality improvement. Implements mechanisms to monitor and evaluate completed tasks for compliance. Participates in policy and decision making initiatives. Makes suggestions to improve organization/program performance. Uses cost effectiveness, cost benefit, and cost utility analyses in programmatic prioritization and decision making. develops statistical, graphical and narrative reports. Provides consultation and oversight on FPPE and OPPE.

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 08/30/2023. 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 GS-12 position you must have served 52 weeks at the GS-11. 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 GS-11 in the normal line of progression for the occupation in the organization. Qualifying specialized experience would typically include, but are not limited to: .Progressively responsible analytical or administrative, or clinical management or supervisory experience in the healthcare 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) Mission, 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. Examples of specialized experience would typically include, but are not limited to: provide consulting and guidance to staff on credentialing and privileging programs, apply strategies for quality improvement, resolves complaints from employees, completes performance reviews and data analysis of credentialing and privileging and processing times of new hires, utilize staffing resources, hiring and fill vacancies, reports and data monitoring, oversee internal controls and audits, You will be rated on the following Competencies for this position: Administration and ManagementAuditingCommunicationLead or SuperviseQuality AssuranceTechnical Competence 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.

Contacts

  • Address Pittsburgh VA Medical Center 1010 Delafield Road Pittsburgh, PA 15215 US
  • Name: Christene Ammoscato
  • Phone: (570) 824-3521 X24536
  • Email: [email protected]

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