The incumbent oversees all functions related to healthcare providers' professional credentials for Oklahoma City Area Indian Health. The incumbent will ensure quality assurance and provide oversight. Serves as a Senior Technical Advisor and a primary consultant and Credentialing liaison. The incumbent outlines program goals and objectives, identifies risks, provides support to the Clinical Director, and ensures training and education for personnel, and completes second level reviews.

Duties

Provides consulting and guidance to local leadership Determines appropriate actions, including those from OCA 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. Incumbent 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, Federal Tort Claims and adverse actions, Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE) reviews and completion timeframes. Serves as a primary consultant for the local Credentialing program; analyzes program audit results; interprets the facility's quarterly report card data; researches provider credentialing requirements; drafts facility Medical Staff Bylaws updates and revisions; interprets and explains new regulatory requirements, and IHS 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 electronic credentialing program User Access; assists with Joint Commission surveys, and Office of Inspector General and Government Accountability Office reviews. Coordinates with Service Chiefs and service level administrative teams for annual Committee(s) review of clinical privileges and scope of practice forms; reviews clinical privileges and scope of practices for accuracy, setting specific indicator and signature appropriations as required for IHS compliance with Joint Commission Standards; updates clinical privilege forms. The incumbent is responsible to ensure employees are efficiently and effectively accomplishing quality work that is compliant with regulatory requirements and procedures, TJC standards, laws, and IHS C&P policies and requirements, as well as assuring implementation and accomplishment of the goals and objectives

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. 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: GS-11: One year of specialized experience equivalent to at least the GS-09 level in the Federal service as described in the vacancy announcement. Examples include: independently coordinating the credentialing and privileging process for a health care facility, developing and maintaining health care processes to maintain accreditation; Fosters ongoing delivery of quality comprehensive health services through quality improvement activities; Communicating to management concerns of health care facilities; Facilitating the coordination of credentialing and re-credentialing activities; Maintaining comprehensive records documenting governing board oversight; Maintaining current and complete copies of governing board and medical staff bylaws. Evaluating medical staff files to determine appropriate response to incoming requests for verification of hospital affiliation and clinical privileges from other healthcare facilities and state licensing agencies. AND/OR Education: Completed a Ph.D. or equivalent doctoral degree or 3 full years (54 semester hours) of progressively higher level graduate education leading to such a degree, such education must demonstrate the knowledge, skills, and abilities necessary to do the work or LL.M., if related. AND/OR Combining Education and Experience: Combination of education and experience that when combined fully meet the minimum qualifications for this position. The total percentage equals at least 100 percent to qualify for this GS-11 grade level. Must submit transcripts. Graduate Education: One year of full-time graduate education is considered to be the number of credit hours that the school attended has determined to represent 1 year of full-time study. If that information cannot be obtained from the school, 18 semester hours should be considered as satisfying the 1 year of full-time study requirement. 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

This position has an education requirement. You are strongly encouraged to submit a copy of your transcripts or a list of your courses including titles, credit hours completed, and grades. Unofficial transcripts will be accepted in the application package. Official transcripts will be required from all selectees prior to receiving an official offer.

Only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education may be credited. Applicants can verify accreditation at the following website: https://www.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 Claremore Service Unit 101 S Moore Claremore, OK 74017 US
• Name: Raquel Sells
• Phone: 918-342-6681
• Email: [email protected]