The Supervisory Program Specialist is located in the Consolidated Patient Account Center (CPAC) in the organization of the Chief Operating Officer (COO) and serves as the Insurance Verification Supervisor. The CPAC is a regionally consolidated business entity established to enhance revenue operations throughout the VHA network by standardization and consolidation functions.

Duties

Duties may include but are not limited to: Assigns and reviews work on a daily, weekly or monthly basis. Plans work, sets and adjust short-term priorities, and prepares schedules for the completion of work. Establishes performance standards and requirements and evaluates employee performance. Provides management guidance, direction, and supervision to the CPAC's Insurance Verification Program operations. Implements processes and procedures for staff to contact insurance carriers to ascertain all benefits the veteran or policyholder is entitled to under the health insurance plan. Assures that staff analyzes, interprets, and ensures timely input of all information gathered during phone conversation with insurance carrier representatives in the VA insurance database. Monitors the integrity of the insurance file database by ascertaining that data is timely and accurate. Reviews and evaluates insurance data to determine the necessity to merge like insurance plans and/or companies and/or to add new insurance plans/companies. Analyzes insurance information and data to determine to delete outdated insurance plans and/or companies. Provides guidance and assistance for the review of Explanation of Benefits (EOB) as necessary to identify insurance information. Reviews Claims Tracking files for proper pre-certification. Responds to phone inquiries from veterans or their family members. Participates in training programs and organizational strategies to identify opportunities to improve customer service and quality. Facilitates the innovative application of industry and agency best practices and quality management methods. Work Schedule: Monday through Friday, 8:00am to 4:30pm Compressed/Flexible: Available Telework: VA supports the use of telework as a way to help attract and retain talented individuals in public service, increase worker productivity, and better prepare the agency to operate during emergencies. This position may be authorized for telework. Telework eligibility will be discussed during the interview process. Virtual: This is not a virtual position. Position Description/PD#: Supervisory Program Specialist/PD00087A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved 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, 12/06/2023. 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-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: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-7 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Adapting and interpreting of all VA regulations, Public Laws, Directives and policy memorandums the Medical Care Cost Recovery (MCCR) processes; Communicating in writing to prepare routine correspondence, reports, memoranda and other written products; Examining patient insurance files for accurate and current data; Analyzing insurance information and data to determine accuracy; and Establishing performance standards and requirements and evaluating employee performance. (NOTE: This experience must be well documented in your resume); 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 euivalent 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 only graduate education in excess of the amount required for the next lower grade level may be used to qualify applicants for positions at grades GS-9. You will be rated on the following Competencies for this position: Customer Service Decision Making Communication Analytical Reasoning Teaching Others 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 performed mainly in a sedentary manner, however, walking, standing, reaching, and bending is required. Work Environment: The work environment involves every day risks and/or discomforts requiring normal safety precautions typical of a hospital setting. 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 MACPAC Asheville 730 128 Bingham Rd. Suite #500 Asheville, NC 28806 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]