This position is organizationally located in the Contract Health Branch, Rosebud Service Unit, Indian Health Service. The purpose of this position is to provide support and technical assistance to the Service Unit management on matters involving Contract Health Services. This position is an open until filled. The first Cut-off date for applications to be considered for available vacant positions will be 10 business days after the JOA open date starting 12/06/23, 12/20/23, 01/08/24.

Duties

Assists in developing policies and procedures in the CHS program. Performs liaison functions with contract health providers, state and local agencies. Performs high cost case management of expenditures for determining those cases with catastrophic illnesses in order to receive reimbursement. Responsible for evaluating pertinent contract health cases and assembling, analyzing and checking statistical data. Offers Contract Health Service assistance to eligible Indian people within fund limitations and operates within medical priorities.

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 REQUIREMENT(S): OPM Link: Health System Administration Series 0671 (opm.gov) 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. In addition to the Basic Requirements, you must also meet the Minimum Qualifications stated below. MINIMUM QUALIFICATIONS: GS-9: One (1) years of specialized experience equivalent to at least the GS-7 grade level and/or 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-11: One (1) years of specialized experience equivalent to at least the GS-9 grade level and/or 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. 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: Specialized Experience GS-9: Duties are of a trainee level, provide assistance to supervisor and staff in monitoring expenditures of services provided to beneficiaries; assist with explaining eligibility for services to beneficiaries; drafts correspondence and reports for manager and senior staff review; work with automated financial reporting systems. GS-11: Provide technical support and assistance to program staff and facility staff on matters involving oversight and management of various services, i.e., medical, surgical, dental and ancillary to eligible beneficiaries; perform high cost case management of expenditures to determine cases that may include catastrophic illnesses; advise and educate beneficiaries on eligibility of services; assist with monitoring of fund control and appropriate use of dollars spent on allowed services; audits claims processed for patient eligibility for third part programs ensure proper codes submitted to cover primary provider, diagnosis and clinic. 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 Rosebud Service Unit PO Box 400 400 Soldier Creek Road Rosebud, SD 57570 US
• Name: Joseph Dudley
• Phone: 605-226-7203
• Email: [email protected]