The Credentialing Specialist is assigned to the Credentialing and Privileging Office, which is under the Chief of Staff at a VA Medical Center (VAMC) and is responsible for providing administrative and technical direction and support to the credentialing operations. The Credentialing Specialist is responsible for collecting relevant data and the decision-making process to ensure that qualified health care professionals are providing appropriate care in appropriate settings.

Duties

The Credentialing Specialist has continuing responsibility for specialized duties to accomplish the mission and function of the credentials program at the VAMC. Serves as subject matter expert (SME) in the field of credentialing. Uses significant judgement to inform leadership and appropriate administrative staff of program changes, new regulatory requirements, policies and procedures or issues and concerns pertaining to the credentialing program. Assists C&P Manager or Analyst in drafting local credentialing procedures for LIP and Non-LIPs. Receives and reviews correspondence and communications for the credentials function and determines which items require immediate attention and which are confidential in nature. Receives and reviews VetPro reports detecting problem areas requiring further investigation. Upon identification of a problem, researches reference materials, regulations, and standards to identify appropriate action necessary to correct the problem. Issues of a serious nature are elevated to C&P Manager/Analyst for guidance. Manages provider applications (initial) for Non-LIPs credentialing within the VAMC. Credentialing Specialist must have knowledge of medical specialties. Upon receipt of individual credentials' files for review, Credentialing Specialist ensures primary source verification to include, but not limited to, state licenses, certifications, and required certifications. Primary source verification includes, but may not be limited to, the National Practitioner Data Bank (NPDB), state licensing agencies, specialty certification boards, universities, DoD and healthcare facilities and assist with verification of LIP applications. Assures application packages and other documents meet technical requirements per specialty of provider and assures application folder and database account (VetPro or other internal databases and spreadsheets) meet technical requirements. Analyzes and manages issues related to documents that do not meet expected requirements, regulations or guidelines such as adverse actions against licensures, certifications, and NPDB) CQ reports. Conducts final appointment into the VetPro database, after thoroughly researching, analyzing and validating all data, information, documents and signature authorities. The incumbent is responsible for compliance with all purchase card requirements including reconciling transactions and resolving discrepancies with Fiscal Service. Incumbent is an authorized user of the Government Purchase Card. VA offers a comprehensive total rewards package: HR Specialist Total Rewards Work Schedule: Monday - Friday, 8:00am - 4:30pm 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. Virtual: This is not a virtual position. Position Description/PD#: Program Support Assistant (Credentialing)/PD99868A 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, 09/22/2023. 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-07 position you must have served 52 weeks at the GS-06. 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-06 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: utilizing office automation to maintain files, generate reports and create documents; experience performing customer service duties such as assisting with completion of forms; verifying of information in health care provider files; maintaining confidentiality of information in accordance with the Privacy Act; using software applications such as word processing and data bases and internet database applications for data entry, file maintenance and data retrieval; researching reference materials, regulations, and standards to identify appropriate action necessary to correct problems or issues.. . You will be rated on the following Competencies for this position: Database Management Systems Audit Reporting Communication Technical 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 sedentary. Some work may require movement between offices, hospitals, warehouses, and similar areas for meetings and to conduct work. Work may also require walking/standing, in conjunctions with travel to and attendance at meetings and/or conferences away from the work site. Incumbent may carry and lift light items weighing less than 15 pounds. 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 VA TX Valley Coastal Bend HCS 2601 Veterans Drive Harlingen, TX 78550 US
• Name: VISN 17 SSU USAS Group
• Email: [email protected]