This position is assigned to the Specialty Program Department, Veteran and Family Member Program (VMFP) Directorate of the Department of Veteran Affairs (VA), Veterans Health Administration Office of Integrated Veteran Care (IVC). The incumbent is regarded as an expert regarding business process functions related to health care claims processing, claims reimbursement queues, resolution team functions, vendor file management, and third party identification.

Duties

Duties include, but may not be limited to: Serves as a technical expert as it relates to the operations i.e., new programs and/or initiatives that have a direct impact on claims processing for several programs to include the Spina Bifida Health Care Benefits, Children of Women Vietnam Veterans, and the Camp Lejeune Family Member Program. Assists in the development and implementation of internal control and auditing methodologies to ensure full compliance with sound quality controls. Recommends and implements changes to improve the effectiveness of work methods and procedures, manpower utilization, distribution of work assignments. Identifies and recommends solutions when effectiveness of existing procedures and policy is no longer effective or demonstrated. Exercises supervisory authorities and responsibilities involving work assignment and review, as well as the administrative and personnel management functions relative to the staff supervised. Develops work improvement plans, recommends disciplinary measures and personnel administrative actions as necessary. Plans, directs, and supervises work to be accomplished by subordinates, sets and adjusts short-term priorities, and prepares schedules for completion of work. Maintains sponsor and beneficiary file records in accordance with established guidelines and ensures that records are properly scanned into system accurately and within established time frames. Work Schedule: Monday-Friday, Between 6:00am-4:30pm (Negotiable) Telework: 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. Position Description/PD#: Supervisory Program Analyst/PD604360 and PD604350 Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): 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, 09/11/2023. 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-09 position, you must have served 52 weeks at the GS-07. For a GS-11 position, you must have served 52 weeks at the GS-09. 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-09 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-09 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Applying analytical and evaluative techniques to the identification, consideration, and resolution of issues or problems of a procedural or factual nature. Display experience in management and organization, including administrative practices and procedures common to organizations such as channels of communication, delegation of authority, routing of correspondence, filing systems, and storage of files and records. Conduct interviews with supervisors and employees to obtain information about organizational missions, functions, and work procedures. Utilize qualitative and quantitative analytical techniques to complete assignments including literature search, task analysis and job structuring, determining staff to workload ratios, and flowcharting of work processes. Plans, coordinates, and carries out the successive steps in fact-finding and analysis of issues necessary to complete each phase of assigned projects; OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree or LL.B. or J.D., if related. OR, Combination: Applicants may also combine education and experience to qualify at this level. You may qualify on a combination of education and experience, the total percentage of experience at the required grade level compared to the specialized experience requirement, as well as the percentage of completed education compared to the educational requirement must equal at least 100 percent GS-11 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-09 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Possess the examiner skills and knowledge needed to accomplish the functions of the position, including the coordination of benefits and application of the financial laws, regulations, manuals, procedures, and practices regarding entitlement to payment of all types of invoices/vouchers. Make proper disposition of claims for compensation of medical care and to complete the required auditing, research, documentation, and letters, applying knowledge of medical terminology and the relationship between disease or injury to the treatment rendered. Research a variety of complicated transactions to analyze and resolve issues involving payment and denials of claims utilizing automated healthcare claims processing systems, methods, procedures, and techniques. Calculate and verify arithmetical computations and adjustments and transcribing facts and figures based on various supporting documents, forms, rates, pro-rations, potential back payments, and other unique factors and circumstances. Complete data entry transfer, calculations, and decision disposition utilizing knowledge of complex types of claims regarding the processing of transactions based on statutes or policies; OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a Ph.D. or equivalent doctoral degree, or 3 full years of progressively higher level graduate education leading to such a degree, or LL.M., if related. OR, Combination: Applicants may also combine education and experience to qualify at this level. You may qualify on a combination of education and experience, the total percentage of experience at the required grade level compared to the specialized experience requirement, as well as the percentage of completed education compared to the educational requirement must equal at least 100 percent You will be rated on the following Competencies for this position: Analytical ReasoningCompliancePlanning 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: Work involves movement throughout the Health Administration Center. 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

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.

Contacts

• Address Workforce Management - Community Care 120 SE 6th Street Suite 102 Topeka, KS 66603 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]