The Loma Linda VA Health Care System is seeking a Health System Specialist (Credentialing & Privileging) to conduct the credentialing and privileging process of the Jerry L Pettis VA Medical Center's clinical services providers including full-time, part-time, temporary, intermittent, contract, without compensation (WOC), fee basis and telehealth Licensed Independent Providers (LIPs), as defined in the VAMC Medical Staff Bylaws.

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 assists the C&P Manager/Analyst in developing short- and long-term goals necessary to accomplish the mission of the C&P program. Serves as SME in the field of credentials and clinical privileging. Keeps leadership and appropriate administrative staff informed of program changes, new regulatory requirements, and policies and procedures pertaining to the C&P process. Assists C&P Manager/Analyst in drafting local credentialing processes and Medical Staff Bylaws in compliance with all applicable regulations. Receives and reviews correspondence and communications for the C&P function and determines which items require immediate attention and which are confidential in nature. Ensures accurate provider data is entered into and maintained in the VetPro computer program. Ensures current information is present on providers relative to state licensure, Drug Enforcement Organization (DEA) license, National Practitioner Data Bank (NPDB) Continuous Query (CQ) enrollments and renewals, Federation of State Medical Boards (FSMB), documentation of professional education, specialty medical training, certifications, adverse licensure or privileging actions, initial and renewal of privileges which may affect the status of privileges granted for medical practice. Manages provider applications (initial and renewals) for LIPs C&P within the VAMC. Provides guidance and instruction to hospital staff in completing the required documentation of establishing privileges for LIPs. Upon receipt of individual credentials' files for review, incumbent ensures primary source verification to include, but not limited to, state licenses, DEA license, certifications, medical specialty training, and board certifications. 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. Serves as technical advisor to the Executive Committee of the Medical Staff (ECMS) and if applicable the Credentials Committee. Researches and reviews related literature and regulations to keep informed of current requirements in the credentials and privileging arena as they affect health care providers within the VAMC. Prepares agendas for credentials related meetings, ensures those involved are notified of expectations, and ensures appropriate paperwork is accomplished completely and accurately prepared for committee action. Has responsibility to ensure LIPs credentials files (2-part folders) are prepared properly, maintained appropriately, and are accurate and current. Conducts final appointment into the VetPro database, after thoroughly researching, analyzing and validating all data, information, documents and signature authorities. Develops and provides routine and special reports as requested by the C&P Manager/Analyst. Composes correspondence requiring Clinical Service Chiefs, Chief of Staff and Medical Center Director signatures for privileging actions. Incumbent holds the credit card and is responsible for maintaining records, reconciling monthly charge statements and verifying legitimacy of requests for NPDB CQ enrollments/ renewals, licensure verification (if applicable), Educational Commission for Foreign Medical Graduates , American Medical Association, FSMB, National Student Clearing House, Work Number and, board certification (if applicable). Provides ongoing review of regulatory requirements, TJC Standards, changing laws and legal precedents to review hospital regulations and make necessary recommendations for changes to ensure compliance with current VHA, and, TJC Standards and in the event of an emergency declaration. 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: Full Time, Monday - Friday, 8:00 am - 4:30 pm Virtual: This is not a virtual position. Position Description/PD#: Health System Specialist (Credentialing & Privileging)/PD99876A Relocation/Recruitment Incentives: Not authorized Permanent Change of Station (PCS): Not authorized PCS Appraised Value Offer (AVO): 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, 12/11/2023. 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-09 position you must have served 52 weeks at the GS-07. The grade 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 s described below: TO QUALIFY FOR A GS-0671-09 HEALTH SYSTEMS SPECIALIST (CREDENTIALING & PRIVILEGING SPECIALIST) Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-07 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: 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. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a 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 in the areas of Hospital Administration, Public Health Administration, or related fields, such as Business, or Public Administration with course work in Health Care Administration OR, Combination: Applicants may also combine education and experience to qualify at this level. You will be rated on the following Competencies for this position: Attention to DetailCommunicationsComplianceManages and Organizes InformationTechnical Credibility 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. The work is performed in an office setting which require normal safety precautions typical for offices and meeting rooms. The work area is adequately lighted, heated, and ventilated. 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 Jerry L Pettis Memorial Veterans Hospital 11201 Benton Street Loma Linda, CA 92357 US
• Name: Mianna Arrington
• Phone: 253-304-7374
• Email: [email protected]