The Wilmington VA Medical Center is recruiting for a Health Systems Specialist (Credentialing and Privileging Manager). This position is assigned to the Medical Staff Office, which is under the Chief of Staff (COS) at VAMC.

Duties

Provides direct technical and administrative supervision to employees in the Credentialing Office. Manages staff performance by setting and adjusting short and long-term priorities; assesses staffing needs; plans work to be accomplished. Develops, modifies, and/or interprets performance standards; outlines and explains performance expectations to staff. Provides advice, counsel, and instruction to employees on work and administrative matters. Identifies developmental and training needs of employees and provides/arranges for needed development and training. Provides consulting and guidance to local leadership and credentialing employees on all matters pertaining to the credentialing program. Attends committee meetings and presents providers' credentials, clinical practice histories and red flags. Performs as the subject matter expert for credentialing updates to Human Resources, providers and hiring services. ??????? Attends meetings, conferences and seminars to assist with the identification of areas needing improvement. Interprets and explains new regulatory requirements, procedures and processes.??????? Reviews clinical privileges and scope of practices for accuracy, setting specific indicator and signature appropriations as required for compliance. Ensures all mandatory reviews and recommendations are documented in an electronic credentialing database.??????? Leads external and internal regulatory and accrediting investigation issues surrounding credentialing, privileging, and/or reporting. Assists with developing, coordinating and recommending changes for the improvement of workflow in the program or section area.??????? Manages query submissions and results; ensures that primary source verifications are obtained and processed via quality control review. Identifies and presents to leadership the resources necessary for accomplishing the mission and function of the credentialing program. Implement mechanisms to monitor and evaluate completed tasks for their compliance with established policies and procedures. Develops and utilizes analytical and diagnostic tools to identify, evaluate, and recommend to management techniques for developing new or modified work methods. Validates processes that are working efficiently and according to plan to identify dysfunctional process issues as early as possible during the implementation phase. Uses cost-effectiveness, cost-benefit, and cost-utility analyses in programmatic prioritization and decision making. Preferred experience: 3 Years of credentialing experience. Work Schedule: Monday - Friday, 8:00 a.m. to 4:30 p.m. 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#: Health System Specialist/PD99874A Relocation/Recruitment Incentives: 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, 12/28/2023. 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-12 position you must have served 52 weeks at the GS-11. 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. 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-11 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: All of the experience listed under the Grade 11, and a comprehensive knowledge of the VetPro software and its functionality and VetPro policies. Detailed working knowledge of the VA health care and credentialing industry, including medical-legal issues and laws, regulatory standards as related to credentialing, privileging and peer review, and other national standards. Comprehensive knowledge of the principles, provisions and practices of credentialing and accreditation and regulatory agencies such as TJC, Office of Inspector General/Combined Assessment Program (OIG/CAP) and Government Accountability Office (GAO). Experience providing consulting and guidance to local leadership on all matters pertaining to the facility's Credentialing and Privileging program. Experience providing consultation and guidance to local VA leadership on all matters pertaining to the VA's C&P Program. Broad knowledge and skill in Staffing regulations/requirements for health care practitioners for compliance with a range of National and Local Handbooks, Directives, MOUs, Policies, Medical Bylaws, etc.; internal and external regulatory and accrediting agencies such as TJC, CARF, URAC, NPDB, etc. (This experience must be well documented in your resume or application package. Preferred experience: 3 Years of credentialing experience. You will be rated on the following Competencies for this position: Administration and ManagementInterpersonal SkillsLeadershipQuality 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

There is no educational substitution at this grade level.

Contacts

• Address Wilmington VA Medical Center 1601 Kirkwood Highway Wilmington, DE 19805 US
• Name: Rhonda Williams
• Email: [email protected]