The Health System Specialist -Credentialing and Privileging Specialist is assigned to the Medical Staff 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 and privileging (C&P) operations. The C&P Specialist is aligned to and supervised by the C&P Manager.

Duties

The incumbent ensures compliance with VHA policies, directives, memos and notices of The Joint Commission (TJC) standards, recommendations by the Office of Inspector General (OIG) and Government Accountability Office (GAO) and other internal or external auditors and reviewers as appropriate. The incumbent is responsible for collecting relevant data and making informed decisions to ensure qualified health care professionals are providing appropriate care in appropriate settings. Major duties include, but are not limited to: Performing as the subject matter expert (SME) to Licensed Independent Providers (LIPs) and Service Chiefs regarding routine and complex matters related to C&P. Assisting the C&P Manager/Analyst in developing short- and long-term goals necessary to accomplish the mission of the C&P program. Assisting the C&P Manager/Analyst in drafting local credentialing processes and Medical Staff Bylaws in compliance with all applicable regulations. Receiving and reviewing VetPro reports detecting problem areas requiring further investigation. Informing the C&P Manager/Analyst of trends identified, audit results and identified problems that may affect a provider's privilege status. Providing guidance and instruction to hospital staff in completing the required documentation of establishing privileges for LIPs. Assuring 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. Serving as technical advisor to the Executive Committee of the Medical Staff (ECMS) and if applicable the Credentials Committee. Developing and providing routine and special reports as requested by the C&P Manager/Analyst. Establishing and maintains a variety of files and records pertaining to the C&P process. Performs other duties within the C&P program 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 8:00am-4:30pm Telework: Available Virtual: This is not a virtual position. Position Description/PD#: Health System Specialist (Credentialing and Privileging Specialist)/PD99876A 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, 11/21/2023. 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-7 position you must have served 52 weeks at the GS-5. For a GS-9 position, you must have served 52 weeks at the GS-7. 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: Individual Occupational Requirement Undergraduate and Graduate Education: Major study: hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. OR Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade (For GS-7 position 1 year of specialized experience at GS-5, For GS-9 position, 1 year of specialized experience at GS-7) 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. In addition to the Individual Occupational Requirement, you must meet the following: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade in the normal line of progression for the occupation in the organization. (For GS-7 position 1 year of specialized experience at GS-5, For GS-9 position, 1 year of specialized experience at GS-7). Examples of specialized experience would typically include, but are not limited to: Broad and thorough knowledge of pertinent laws, regulations, policies and precedents, accreditation standards and guidelines; Comprehensive knowledge of VetPro policies, including but not limited to, VetPro Data Integrity, Facility level access control, mandatory annual VetPro security and confidentiality training, and mandatory annual privacy act training; Skill in applying analytical and evaluative methods and techniques to issues or studies concerning the efficiency and effectiveness of the C&P operations and toward the planning and accomplishment of a variety of routine and complex work assignments, such as advising leadership on documentation requirements for provider profiling and competence; Ability to communicate orally technical information to a diverse group of individuals with varying levels of understanding; Knowledge of the contacts required for verification of information in health care provider files; Knowledge of medical terminology, medical specialties and core privileges and procedures to assure competence/appropriateness of credentials and privileging requested; Ability to communicate in writing to prepare emails, letters, reports and committee minutes; Skill in using software applications such as word processing and data bases and internet database applications for data entry, file maintenance and data retrieval and analysis; Attention to detail is required to analyze applications, documents, files and other material pertaining to the C&P program; Ability to manage multiple projects and priorities and meet deadlines. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have: GS-07: 1 full year of graduate level education or superior academic achievement GS-09: 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 must have an combination of specialized experience and education beyond post-high school education and experience may be used to meet total qualification requirements for the grade levels specified in the table, and may be computed by first determining the applicant's total qualifying experience as a percentage of the experience required for the grade level; then determining the applicant's education as a percentage of the education required for the grade level; and then adding the two percentages. The total percentages must equal at least 100 percent to qualify an applicant for that grade level. Only graduate education in excess of the amount required for the next lower grade level may be used to qualify applicants for positions at grade GS-9. (When crediting education that requires specific course work, prorate the number of hours of related courses required as a proportion of the total education to be used.) You will be rated on the following Competencies for this position: CommunicationsComplianceQuality AssuranceTechnical 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 mostly sedentary. Occasionally, light physical effort may be required, such as that involved with walking, stair climbing, and carrying of light office items. 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 New Jersey Health Care System 385 Tremont Avenue East Orange, NJ 07018 US
• Name: Kelli Bencic
• Phone: 716-458-6982
• Email: [email protected]