The Cincinnati, OH VA Medical Center (VAMC) is recruiting for a Supervisory Health Systems Specialist (Credentialing and Privileging Manager). The person selected for this position will need to possess specialized and extensive experience in credentialing and privileging within the VA, along with supervisory experience. This position is assigned to the Medical Staff Office, which is reports to under the Chief of Staff (COS).

Duties

The supervisor in this position: Oversees functions related to healthcare providers' professional credentials supporting the divisions of CVAMC in accordance with VHA Credentialing and Privileging (C&P), Directives, VA Handbooks, Policies, Memos, and Notices; The Joint Commission (TJC) Standards and State and Federal Regulations. Works collaboratively with local and VISN leadership to identify and/or implement best practices. Ensures quality assurance and provides oversight for the C&P program. Ensures Medical Staff Bylaws/Rules and Regulations are reviewed and updated as needed to reflect regulations or accreditation standards. Serves as Senior Technical Advisor/primary consultant/liaison to VISN C&P Office. Duties include but are not limited to: Supervisory: provides direct technical and administrative supervision to employees in the CVAMC's C&P Office. Responsible for ensuring employees are efficiently and effectively accomplishing quality work, which is compliant with regulatory requirements and procedures, TJC standards, laws, and VHA C&P policies and requirements. Assures implementation and accomplishment of goals and objectives of the C&P Program. The supervisor outlines C&P program goals and objectives, identifies risks, supervises C&P employees, ensures training/education, and completes 2nd level reviews. Senior Program Advisor: Provides consulting and guidance to local leadership and C&P employees on matters pertaining to the facility's C&P program including Healthcare Professionals' C&P; facility Scope of Practices; National and VISN Memorandums of Understanding; Veterans' Administration Memorandums; VHA requirements, Handbooks, Directives and Policies; TJC Standards; quality assurance assessments; risk management and malpractice claim action evaluations. Determines appropriate actions, including those resulting from VISN and local level reviews, initial and re-credentialing processes, including, but not limited to primary source verifications; reporting and data trends, identified issues that require further review, and electronic credentialing database and clinical privilege maintenance. Supervisor attends committee meetings and presents providers' credentials, clinical practice histories and red flags; documents and composes committee minutes, privileging requests and/or actions, malpractice payments, tort claims and adverse actions, Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE) reviews and completion timeframes. Is the POC/SME for all Human Resources matters, ensuring C&P requirements are completed on providers prior to patient care activity; State Licensing Board Reporting; electronic credentialing database actions and training; VETPro quarterly access reports; Our Providers quarterly certifications; provider and credentialer VETPro accounts. Quality Assurance: Responsible for ensuring quality assurance in the facility's C&P program. This involves applying organizational and system-wide strategies for continuous quality improvement as they relate to C&P processes and procedures. Implements mechanisms to monitor and evaluate completed tasks for their compliance with established policies and procedures as well as quality of customer service. Participates in policy and decision-making initiatives at the VAMC, and continuously develops a greater understanding of regulatory and policy requirements, quality assurance methodologies as well as best practices. Conducts supervisory reviews of completed tasks, present information, and make recommendations on how to improve. Utilizes evaluation results to make suggestions and improve organization/program performance. Uses cost-effectiveness, cost-benefit, and cost-utility analyses in programmatic prioritization and decision making. Performs internal reviews and audits of current systems and policies. Performs quality assurance checks. Program Account Administrator: Serves as the administrator for the TRJC. This involves managing enrollments, single queries and re-enrollments; preparing and submitting reports for adverse privileging actions; submitting federal tort claims for substandard clinical care per the Office of General Counsel; ensuring primary source verification is obtained and processed via quality control review. Serves as the administrator for the Federation of Medical Boards and acts as the administrator for the Our Providers Database. Performs other C&P program related duties as assigned. Work Schedule: 7:30am to 4:00pm 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.

Requirements

Qualifications

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 Health System Specialist/PD99417S To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 04/08/2024. 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-09. The grade may have been in any occupation, but must have been held in the Federal service. An SF50 that shows your time-in-grade eligibility must be submitted with your application materials. If the most recent SF50 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 SF50 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-09 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Detailed working knowledge of the 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. Experience with medical staff/practitioner credentialing and privileging in a health care environment. Daily exposure to Credentialing and Privileging operations: Completing credentialing and re-credentialing processes for all medical providers who provide patient care at a healthcare facility. Ensures healthcare providers are credentialed, appointed, and privileged. Experience preparing and processing credentialing packets for healthcare providers. Verifying the provider's qualifications (education, training, experience, and licensure to provide services) to ensure the provider can provide medical services. Requests documentation and verifies the documentation through primary sources for healthcare workers. Experience populating, maintaining, and updating credentialing databases to ensure accountability for the integrity of the information entered in the system. Maintains the provider's state licenses, DEA certificates, malpractice insurance and any other expirable documents. Maintains up-to-date data for each healthcare provider in credentialing databases and online systems and ensures timely renewal of licenses and certifications. Ensures the personnel of a healthcare facility are properly trained, licensed and certified as mandated by state and federal regulations. Communicates with doctors, healthcare administrators, higher education institutions and government officials regarding the healthcare provider's credentials. Comprehensive knowledge on medical licensing and certification requirements, medical specialties, medical terminology; credentialing programs, credentialing and privileging rules, regulations, and standards. (This experience must be well documented in your resume or application package). . OR Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a 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. Please Note: Major study -- hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. Education at the graduate level must be from an accredited college or university. If you are qualifying on education, transcripts are required. OR Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience (mentioned above) and education (mentioned above) beyond semester hours (2 years) of graduate level experience) is creditable. Note: If you select this option, a copy of your transcripts is required. Education cannot be credited without documentation. Your resume must indicate clearly the nature of your duties and responsibilities in each position and the number of hours a week spent in such employment. If you are qualifying on education, transcripts are required. You will be rated on the following Competencies for this position: 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. The work may require travel. No special physical demands are required. Keen hearing and distinct speech are essential due to the extensive use of the telephone as a means of communication. May be a certain amount of mental strain due to time constraints, workload demands, and frequent reviews and surveys. 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 Cincinnati VA Medical Center 3200 Vine Street Cincinnati, OH 45220 US
• Name: Amanda Flores
• Phone: 260-249-9438
• Email: [email protected]