This position serves as a Health Systems Specialist (organizational title is Credentialing & Privileging (C&P) Manager) and is assigned to the Medical Staff Office, which is under the Chief of Staff (COS) at VA Medical Center. The incumbent is responsible for working collaboratively with local and VISN leadership to identify and/or implement best practices and advising VAMC leadership of all program requirements pertaining to the C&P program.

Duties

Major duties include but are not limited to: Determines appropriate actions, including those resulting from VISN and local level reviews, initial and re-credentialing processes, including, but not limited to primary source verifications; reporting and data trends, identified issues that require further review, and electronic credentialing database and clinical privilege maintenance. Attends committee meetings and presents providers' credentials, clinical practice histories and red flags; documents and composes committee minutes, privileging requests and/or actions, malpractice payments, tort claims and adverse actions, Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE) reviews and completion timeframes. Serves as the primary consultant for the facility's C&P program; analyzes program audit results; interprets facility quarterly report card data; researches provider credentialing requirements; identifies potential privileging issues; drafts facility Medical Staff Bylaws updates and revisions; interprets and explains new regulatory requirements, and VHA requirements, procedures and processes; contributes to development of local policies; ensures program compliance; monitors National Practitioner Databank reporting and queries results; prepares Federal and State Medical Boards reports; tracks State Licensing Board reporting; communicates telehealth provider requirements; manages VetPro access levels and training; assists with Joint Commission surveys, and Office of Inspector General and Government Accountability Office reviews. Responsible for ensuring quality assurance in the facility's C&P program which involves applying organizational and system-wide strategies for continuous quality improvement as they relate to C&P processes and procedures. Implements mechanisms to monitor and evaluate completed tasks for their compliance with established policies and procedures as well as quality of customer service. Validates processes that are working efficiently and according to plan to identify dysfunctional process issues as early as possible during the implementation phase. Develop data gathering strategies and work with other services and work teams to obtain the necessary process information. Use data gathered during the analytical phase of studies to create optimized systems. Develop statistical, graphical, and narrative reports justifying training or changes in processes to improve systems effectiveness and efficiency and customer service quality. Serves as the administrator for the Federation of Medical Boards. Other duties as assigned. Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level. Work Schedule: Monday-Friday, 7:30 am to 4:00 pm Telework: VA supports the use of ad hoc 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 ad hoc telework. Telework eligibility will be discussed during the interview process. Virtual: This is not a virtual or remote position. Position Description/PD#: Health System Specialist - Credentialing & Privileging Manager/PD99875S Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required The VA Midwest Health Care Network advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care, you will operate in a model with three core elements, seeking to create a personalized health plan for each Veteran. This is done in the context of healing relationships and healing environments and a connection back to the Veteran's community. This aligns with the Veterans Health Administration (VHA) Mission Statement to Honor America's Veterans by providing exceptional health care that improves their health and well-being.

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 10/18/2023. GS-11 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-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. GS-12 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. GS-11 You may qualify based on your experience and/or education as described below: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-9 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Determining appropriate actions, including those resulting from region and local level reviews, initial and re-credentialing processes, including, but not limited to primary source verifications, reporting and data trends, identified issues that require further review, and electronic credentialing database and clinical privilege maintenance. Implementing mechanisms to monitor and evaluate completed tasks for their compliance with established policies and procedures as well as quality of customer service. OR Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have 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 must have an combination of specialized experience and education beyond 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. GS-12 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. Examples of specialized experience would typically include, but are not limited to: Overseeing all functions related to healthcare providers' professional credentials supporting all divisions of a VA medical center (i.e. full time, part time, temporary, intermittent, contract, without compensation (WOC) and fee basis) in accordance with VHA Credentialing and Privileging (C&P), Directives, VA Handbooks, Policies, Memos, and Notices as well as The Joint Commission (TJC) Standards and State and Federal Regulations. Working collaboratively with local and VISN leadership to identify and/or implement best practices and advising VA Medical Center leadership of all program requirements pertaining to the Credentialing & Privileging program. Ensuring quality assurance and providing oversight for a credentialing and privileging program. There is no educational substitution for the GS-12 grade level. All qualifying experience you possess must be clearly described in your application package. We will not make assumptions when reviewing applications. Please see the Required Documents section below for resume requirements. You will be rated on the following Competencies for this position: Administration and ManagementAnalytical ReasoningQuality Assurance 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: You will be asked to participate in a pre-employment examination or evaluation as part of the pre-employment process for this position. Questions about physical demands or environmental factors may be addressed at the time of evaluation or examination. 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 VA Black Hills Health Care System 113 Comanche Road Fort Meade, SD 57741 US
• Name: Michael Kelly
• Phone: 612-467-3398
• Email: [email protected]