This position is located at Durham VA Health Care System within the Health Administration Service. The incumbent serves as a Medical Administration Specialist (Eligibility and Enrollment Coordinator). The primary purpose of this position is to provide administrative and technical oversight in the Eligibility and Enrollment section. Key functions include but not limited to facilitating all administrative aspects of the enrollment process and related aspects of health benefits administration.

Duties

Duties and responsibilities for this position include but are not limited to the following: The incumbent is responsible for the Eligibility and Enrollment Program. This program is responsible for all administrative processes and health benefits eligibility determinations. The position reports directly to the Assistant Chief of HAS. Performs technical activities involved with screening, processing, and assisting Veterans, non-Veterans and beneficiaries seeking multiple medical treatment benefits. Responsible for establishing procedures to ensure all "front-line" employees involved with Veteran patient contact during the intake and enrollment process receive continuous training and regular status briefings on the enrollment process and health benefits administration. Provides training and education to Medical Center personnel in all matters under the preview of their position, i.e., eligibility and entitlement, etc. Assists in orientating and advising physicians, residents and interns on VA regulations, policies, and procedures as well as determination of legal next-of-kin. Serves as the primary contact for eligibility administrative, clinical and clerical issues for the DVAHCS and is responsible for performing a variety of significant administrative, analytical and technical functions, tasks and special projects with respect to eligibility priorities. Responsible for programmatic oversight of the DVAHCS Eligibility and Enrollment Program. Prepares reports and replies for Chief/Assistant, HAS, and executive leadership in response to internal or externals requests for program information and data such as statistical data to the National Enrollment Program, VISN and/or National reports. Inform management and executive leadership of any problems or trends regarding enrollment issues and health benefits administration. Perform and assists with daily monitoring by formulating data validation activities and analysis reports to supervisors of all required means tests, all completed means tests, EGT Impact, Upcoming Appointments without Enrollment, Preregistration Audits, NEAR, VES usage, Pending applications, Ineligibles, Catastrophics, Hardships, and inconsistency/error reports. Prepares verbal and written responses to inquiries and complaints of Veterans and Congressional staff regarding health care benefits and revenue policies for the purpose of solving problems, explaining procedures, and recommending various courses of action if necessary. Prepares drafts and replies to executive leadership and prepares controlled correspondence for the signature of the Director. Prepares and conducts public speaking presentations to veteran service organization members regarding veterans' health administration benefits. Additional Duties as assigned. Work Schedule: 8:00am - 4:00pm, Monday - Friday 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 Ad-hoc telework. Ad-hoc telework eligibility will be discussed during the interview process. Virtual: This is not a virtual position. Position Description/PD#: Medical Administration Specialist/PD066980 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, 02/05/2024. 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 -11 position you must have served 52 weeks at the GS-9. 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 GS-11: You must have one year of specialized experience equivalent to at least the next lower grade GS-9 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Enrollment and Eligibility for VA Health Care Benefits; data entry and VISTA and ES programs, PDX to obtain patient information from other VA Medical Centers; retrieval of eligibility data from VA sources HINQ, VIS, DPRIS and ensure proper exchange of information with the VARO; program budget and financial analysis techniques; and applying medical terminology and VA nomenclature in order to effectively review and interpret information contained in medical records, rating letters, and rating decisions; Training Experience, ability to lead a team, multi-tasker; administrative and technical knowledge, create reports/action plans, and outreach experience - OR - Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have 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 (Transcript(s) required if using education to qualify) - OR - Combination: Applicants may also combine education and experience to qualify at this level. You must have a combination of specialized experience and education beyond. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work. 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-11 (Transcript(s) required if using education to qualify). You will be rated on the following Competencies for this position: Customer ServiceDecision MakingOrganizational Performance AnalysisTechnical CredibilityWriting 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 primarily sedentary with occasional walking, although some slight physical effort may be required. 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: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

Contacts

• Address Durham VA Medical Center 508 Fulton Street Durham, NC 27705 US
• Name: Natasha Fortenberry
• Phone: 314-459-1741
• Email: [email protected]