The position works under the supervision of the Chief, Business Office, with the primary responsibility encompassing three key functions: facilitating all administrative aspects of the enrollment process; health benefits eligibility determinations, and related aspects of health benefits administration.

Duties

John J. Pershing is committed to Diversity and Inclusion. Together, we strive to create and maintain a working and learning environment that promotes professional growth and teamwork. We offer an inclusive, equitable, and welcoming environment where we celebrate our individual differences and unite as a team toward a common goal of providing outstanding service to our Nation's Veterans. Principle Duties and Responsibilities: Performs technical activities involved with screening, processing, and assisting veterans, non-veterans and beneficiaries seeking multiple medical treatment benefits. Responsible for the Enrollment Program to include all administrative processes, health benefits eligibility determinations and all aspects of the health benefits performed within their immediate section of the Enrollment Department. As the Enrollment Coordinator, the incumbent will be responsible for establishing procedures to ensure all "front-line" employees involved with Veteran patient contact during the intake and enrollment process receive periodic training and regular status briefings on the enrollment process and health benefits administration. The position is a subject matter expert on all enrollment administrative issues for clerks, medical staff, first-line, middle and senior facility management officials of the John J. Pershing VA Medical Center. Responsible for coordinating the implementation of all enrollment software changes to the Enrollment System (ES) software and Veterans Health Information Systems Technology Architecture (VistA) with the local Information Resource Management Staff and the Business Office's Program Application Specialist. Develops program materials, such as Standard Operating Procedures (SOPs), Station Policies, and relays content to clerical staff assigned throughout the Health Care System. Administration of these programs includes daily analyzing of benefit utilization and implementing the extensive body of VA and DoD regulations, rules, policies, procedures and practices associated with inpatient/outpatient activities, as well as veteran/patient entitlement and benefits programs, which include, but not limited to, Champ VA, DoD sharing agreements, all other sharing agreements, Health Care Finance Administration (HCFA) requirements and guidelines, Medicare, Mission Act, and contract services, to ensure that clinical services are provided to eligible beneficiaries. Making appropriate changes to person data in the respective VA medical facility's EHR system and perform POC functions, such as resolving identity data quality issues. Prepares reports and replies for Chief, Business Office, and executive leadership in response to internal or external requests for program information and data such as statistical data to the National Enrollment Program, VISN and/or National reports. Program oversite includes review and monitoring of all enrollment staffs on their performance in administering the VA Form 10-10EZ Application for Health Benefits. Responsible for developing internal review mechanisms for a successful Enrollment Program. 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. Supervisory Duties: Plans work to be accomplished by subordinates, sets and adjusts short-term priorities and prepares schedules for completions of work. Assigns work to subordinates based on priorities, selective consideration of the difficultly and requirements of assignments, and the capabilities of employees. Evaluates the work performance of subordinates; provides advice, counseling or instruction to staff on work and administrative matters. interviews candidates for positions in the unit, recommends appointments, promotions or reassignments to positions. Hears and resolves complaints from employees, referring group grievances and more serious complaints to a higher-level supervisor or manager. Minor disciplinary measures such as warnings/reprimands, and recommends other action for more serious cases; identifies developmental and training needs of the employees providing for and arranging the needed training; finds ways to improve productivity or increase the quality of work directed; and develops performance standards. Work Schedule: Monday-Friday 7:30am-4:00pm or 8:00am-4:30pm Telework: This position may be authorized for telework Adhoc Only Virtual: This is not a virtual position. Position Description/PD#: Medical Management Specialist/PD10238A Financial Disclosure Report: Not required

Requirements

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-09 position you must have served 52 weeks at the GS-07. 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. Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-07 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: demonstrates the ability to supervise in a diverse health administration setting; coordinating and administering a variety of administrative support functions such as supplies, personnel, budget, and management analysis; supervision of an administrative function (identifying organization's financial, personnel, and material needs and problems - advising on and negotiating contracts, agreements, and cooperative arrangements with agencies - experience with developing budget estimates and justifications, etc.); or supervision which involved significant administrative responsibilities within a healthcare environment. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a masters or equivalent 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, from an accredited college or university to qualify for the grade 09 position? (TRANSCRIPT REQUIRED). 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 Applicants may also combine education and experience to qualify at the GS-9 level. To calculate, first identify the percentage of required education you have earned (when substituting, you cannot use the first 60 semester hours that you earned). Then identify the percentage of required experience you possess. Add the two percentages. The total percentage must equal at least 100 percent to qualify at the GS-9. For example, an applicant who has 9 semester hours of graduate level education (i.e. 50% of graduate education required) and 6 months of creditable specialized experience (i.e. 50% of the required experience) would equal 100% of the required experience for the position. (TRANSCRIPT REQUIRED). A transcript must be submitted with your application if you are basing all or part of your qualifications on education. 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. You will be rated on the following Competencies for this position: Administration and ManagementAttention to DetailData ManagementOral Communication 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: Duties involve considerable walking and sitting, and include occasional bending and lifting. A substantial amount of work time involves reading, writing and utilizing computers. 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 John J Pershing VA Medical Center 1500 North Westwood Boulevard Poplar Bluff, MO 63901 US
• Name: Tiffany Coats
• Phone: 615-873-8622
• Email: [email protected]