Job opening: Health System Specialist-Credentialing and Privileging Specialist
Salary: $51 261 - 81 512 per year
Published at: Mar 07 2024
Employment Type: Full-time
OUR MISSION: To fulfill President Lincoln's promise "To care for those who have served in our nation's military and for their families, caregivers, and survivors" - by serving and honoring the men and women who are America's Veterans. How would you like to become a part of a team providing compassionate whole health care to Veterans?
Duties
This position is located in the Chief of Staff Office at the Clement J. Zablocki VA Medical Center (695), a complexity Level 1a VHA facility. This position is responsible for providing administrative and technical direction and support to/performance of the credentialing operations for both Licensed Independent Practitioners (LIPs) and Dependent clinical employees.
The employee serves in a developmental capacity at the GS-07 level. Key functions will be similar to those described at the full performance level of the target position. However, during the developmental assignment, full performance range and level of selected functions will not be completely delegated to the incumbent until proper orientation and training have been completed and the employee has demonstrated the knowledge, skills and abilities necessary to accomplish the work at the full performance level.
-Serves as a Subject Matter Expert (SME) in the field of credentialing and clinical privileging. (both dependent and independent clinician credentialing)
-Keeps leadership and appropriate administrative staff informed of program changes, new regulatory requirements, and policies and procedures.
-Assists management with the drafting of 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.
-Researches reference materials, regulations and standards to identify appropriate action to correct or resolve problems.
-Ensures accurate provider data is entered into and maintained in the VetPro computer program.
-Ensures current information is present on providers related 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, etc.-Serves as the technical advisor to clinical leadership for the development of department specific privileges and assures that complete documentation is available to support privileges granted.
-Provides guidance and instructions to hospital staff in completing the required documentation to establishing privileges for Licensed Independent Providers (LIPs).
-Ensures primary source verification to include 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.-Communicates with LIPs to assure timely completion of applications and VetPro requirements.
-Provides oversight to application process; analyzes exceptions and deviations in expected application process; determines course of action and makes recommendations.-Prepares agendas for credentials related meetings, ensures those involved are notified of expectation, and ensures appropriate paperwork is accomplished completely and accurately prepared for committee action.
-Ensures LIPs credentials files are prepared properly, maintained appropriately, and are accurate and current.
-Conducts final appointment into the VetPro database, after researching, analyzing and validating data, information, documents and signature authorities.-Develops and provides routine and special reports as requested by the C&P Manager/Analyst.
-Holds a purchase card and is responsible for maintaining records, reconciling monthly charge statements and verifying legitimacy of requests for NPDB CQ enrollments/renewals, licensure verification, etc.
-Performs other related 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: Monday-Friday, normal business hours
Compressed/Flexible:
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-Credentialing and Privileging Specialist/PD99876A
Relocation/Recruitment Incentives: Not Authorized
Critical Skills Incentive (CSI): Not Approved
Financial Disclosure Report: Not required
Qualifications
To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 03/14/2024.
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-7 position you must have served 52 weeks at the GS-5. 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.
Specialized Experience GS-7: You must have at least one (1) full year of specialized experience equivalent to the next lower grade (GS-5) in federal service performing work closely related to the work of this job. Specialized Experience for this position consists of: 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. It also includes: Skill to communicate orally technical information to a diverse group of individuals with varying levels of understanding; Knowledge of the contacts required for verification of information in health care provider; Knowledge of medical terminology, medical specialties and core privileges and procedures to assure competence/appropriateness of credentials and privileging requested; Skill to communicate in writing to prepare emails, letters, reports and committee minutes; Skill in using software applications such as word processing and data bases and internet database applications for data entry, file maintenance and data retrieval and analysis.
OR,
Education GS-7: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have successfully completed 1 full year of graduate level education or superior academic achievement. Major study must be in hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration.
Superior Academic Achievement (S.A.A): Applicant who has completed four (4) years of education above high school level leading to a Bachelor's degree may qualify based on S.A.A. by class standing (Standing in the upper third of their class based on completed college work at the time of application for the position) . OR, college grade average of "B" (3.0 or higher on a 4 point scale). OR, college grade average of "B+" (3.5 or higher on a 4 point scale) in the major field, where such field is fully qualifying and directly applicable to the specialty field of the position to be filled. OR, national scholastic honor society membership. (Transcripts Required)
OR,
Combination of Education and Experience GS-7: You must have a combination of successfully completed post-high school education (beyond the 2nd year) AND specialized experience which meet the total experience requirements for this grade level. (Transcripts Required)
Specialized Experience GS-9: One (1) full year of specialized experience that equipped the applicant with the particular knowledge, skill, and abilities to perform successfully the duties of the Health System Specialist (C&P) and is typically in or related to the work of the position to be filled. To be creditable, specialized experience must have been equivalent to at least the next lower grade level in the normal line of progression for the occupation in the organization (GS-7).Specialized Experience for this position consists of: 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. It also includes: Knowledge of pertinent laws, regulations, policies and precedents, accreditation standards and guidelines related to a C&P program; knowledge of credential programs such as VetPro; skill in applying analytical and evaluative methods and techniques to issues or studies concerning the efficiency and effectiveness of a C&P operation; knowledge of the contacts required for verification of information in health care provider files; knowledge of medical terminology, medical specialties and core privileges and procedures to assure competence/appropriateness of credentials and privileging requests; skill in using software applications such as word processing and data bases and internet database applications for data entry, file maintenance and data retrieval and analysis; ability to communicate in writing to prepare emails, letters, reports and committee minutes; and ability to communicate orally technical information to a diverse group of individuals with varying levels of understanding.
OR
Substitution of Education for Specialized Experience - GS-9: A master's or equivalent graduate degree or two (2) full years of progressively higher-level graduate education leading to such a degree or LL. B or J.D.., if related. Major study must be in hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work of the position and been obtained at an accredited college or university. TRANSCRIPTS REQUIRED.
OR
Combining Specialized Experience and Education - GS-9 - Equivalent combinations of experience and education are qualifying for this position. TRANSCRIPTS REQUIRED.
You will be rated on the following Competencies for this position:
Analysis and Problem SolvingAttention to DetailCommunicationComputer Skills
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.
Contacts
- Address Clement J Zablocki Veterans Administration Medical Center
5000 West National Avenue
Milwaukee, WI 53295
US
- Name: Lesley Hynes
- Phone: 414-712-8259
- Email: [email protected]
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