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. Program Account Administrator: Serves as administrator for the NPDB. Manges enrollments, single queries and re-enrollments, prepare and submit reports for adverse privileging actions, submit tort claims for substandard clinical care, ensures primary source verification is obtained. Ensures mandatory reviews and recommendations are documented in electronic credentialing database. Serves as administrator for the Federation of Medical Boards. Administrator for Our Providers Database. Supervisory: Provides direct technical and administrative supervision to employees in C&P Office. Responsible for employees accomplishing quality work, assures implementation and accomplishment of goals and objectives, sets and adjusts short and long term priorities, assess staffing needs, plans work, develops performance standards, assign and review work, evaluates work, provides advise, counsel and instruction to employees. identifies developmental and training needs. Hears and resolves issues and complaints from employees. Interviews and selects candidates. Performs other C&P program related duties as assigned. Work Schedule: Monday - Friday 8am - 4:30pm Position Description Title/PD#: Health System Specialist - C&P/PD99874A 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. Compressed/Flexible: not authorized 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. Virtual: This is not a virtual position.

Requirements

• You must be a U.S. citizen to apply for this job
• Subject to a background/suitability investigation
• May serve a probationary period
• Selective Service Registration is required for males born after 12/31/1959
• A complete application package; Resume, Transcripts, etc.
• Selected applicants will be required to complete an online onboarding process

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement. 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, 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.

Education

There is no educational substitution for the GS-XX 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]