This position is located in the Department of Purchased and Referred Care (PRC) of the Cass Lake Service Unit, Cass Lake, MN. The incumbent serves as Chief, Purchased & Referred Care under the administrative direction of the Service Unit CEO. This position is responsible for all PRC programs, services & activities. It includes the management of PRC funds and resources for referral that are obligated in order to provide authorized health services for patients residing within the PRC service area.

Duties

Assure the local Purchased Referred Care (PRC) program, guidelines, policies and procedures are being followed. Administer a PRC denial and appeal system that provides the Area office with necessary information. Accountable for the maintenance and control of PRC funds for medical services. Monitor and issue Medical Purchase Orders (MPO) for medical services provided to patients and maintains follow-up, tracking MPOs.

Requirements

Qualifications

To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying. 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; religious; spiritual; community; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week. Basic Requirements Individual Occupation Requirements Specialized Experience (for positions above GS-5): Progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care 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: Missions, organizations, programs, and requirements of health care delivery systems; Regulations and standards of various regulatory and credentialing groups; and Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement. MINIMUM QUALIFICATIONS: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Managing a purchased referred care department, responsible for the evaluation and reporting, and performing liaison functions with contract providers, state, local and tribal agencies. Time In Grade Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP). You must meet all qualification requirements within 30 days of the closing date of the announcement.

Education

There are no education requirements.

Contacts

• Address Cass Lake Service Unit 425 7th Street NW Cass Lake, MN 56633 US
• Name: Robby Chasing Hawk
• Phone: 218-335-3268
• Email: [email protected]