This position is located in a Department of Veterans Affairs, Seattle Regional Office (VARO), Disability Rating Activity Section (DRAS). The Rating Quality Review Specialist is an integral part of the RO's quality assurance program, and is a key technical adviser to the Decision Review Officers (DROs) and Rating Veterans Service Representatives (RVSRs), in the Regional Office.

Duties

The purpose of this position is to measure individual performance quality and identify training needs through the review and assessment of completed claims involving appeals and rating decisions. Major Duties: The Rating/Appeals Quality Review Specialist is responsible for performing quality reviews for the individual DROs and RVSRs in accordance with an established monthly schedule. Results of station reviews will indicate the appeals and rating quality level for the station. Some of the cases reviewed for the station will be subject to Central Office STAR review. The Rating/Appeals Quality Review Specialist performs individual quality reviews to determine the appeals and rating quality level of individual DROs and RVSRs for purposes of individual performance standards. The STAR worksheet will be used for both reviews. The incumbent tracks and analyzes all appeals and rating quality exceptions for the station and for individuals, to include exceptions called by Central Office. The Rating/Appeals Quality Review Specialist is responsible for sharing authorization quality trend information with management on an ongoing basis and with the DROs and RVSRs during training sessions. The individual develops reports and discusses report findings with the Veterans Service Center Manager, Coaches, and employees on a routine basis. Maintains secure records showing the cases reviewed and the types and number of errors found as required by the performance standards. The incumbent reviews products or activities for quality of performance and enters the results into the on-line STAR checklists. Evaluates and identifies deficiencies of all elements of a claim from evidence development, through rating and appeal decisions. Provides an explanation of errors and includes comments where attention is warranted. Returns completed claims called in error to the originating DRO or RVSR for correction. The outcome of reviews is to improve performance especially in accuracy, timeliness and customer satisfaction. When warranted, assists the Coach in conducting expanded reviews if individual performance is found to be deficient. Interacts with supervisory personnel through discussion of individual claims that have been reviewed. Explains rationale and provides appropriate citation to support an error call. As determined by local union and management agreement, may provide feedback to the DRO or RVSR. Prepares STAR data reports and provides to personnel in the regional office who are authorized to request and receive such reports. Performs administrative functions (i.e., providing feedback on reviews and maintaining reports). Utilizes STAR review results and identified trends to recommend training for Decision Review 5% Officers and Rating Veterans Service Representatives. Analyzes available data which reflects quality levels to determine training needs of new DROs and lower-graded RVSRs. The Rating/Appeals Quality Review Specialist will also work collaboratively with the Authorization Quality Review Specialist to identify overall station trends and training needs, primarily in the development portion of claims processing where there is considerable overlap. Prepares and conducts formal training sessions; including but not limited to training for newly hired personnel, refresher training and other necessary training due to changes in procedures, regulations, or the law. The incumbent provides assessments to the first-line supervisor detailing strengths and weaknesses observed in the trainees and identify ways for improvement in performance. He/she provides periodic assessments to division management on the quality of the work produced by all authorization personnel, including trainees. The incumbent develops methods for mentoring members of the team on the technical aspects of the job in a manner which addresses individual learning needs and effectively offers feedback to identify and correct deficient areas. Performs in-depth research, analyzes operating contingencies and special situations. Assists technical managers and staff in developing claims processing solutions. Conducts statistical analysis of STAR reviews to identify trends in quality, significant problems areas and processes requiring improvement. Performs quality management activities that are designed to improve quality of case processing. Monitors qualitative and quantitative measurements to identify quality program trends. Identifies areas requiring further analysis. Work Schedule: 7:30AM-4:00PM Compressed/Flexible: Available Telework: Yes - as determined by the agency policy Virtual/Remote: This is NOT a virtual/remote position Position Description/PD#: Decision Review Officer (RQRS) 37138A Relocation/Recruitment Incentives: Not Authorized Financial Disclosure Report: Not Required

Requirements

• You must be a U.S. Citizen to apply for this job
• Selective Service Registration is required for males born after 12/31/1959
• You may be required to serve a probationary period
• Subject to background/security investigation
• Selected applicants will be required to complete an online onboarding process

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 04/16/2024. 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-13 position you must have served 52 weeks at the GS-12. 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. 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 as described below: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-12 in the normal line of progression for the occupation in the organization. Specialized Experience is defined as work that involves functioning in either a capacity performing training, analyst, or information systems duties of a claim's management process. The experience should be substantive and relevant and may have been gained in the federal, military, or private sector. Examples of specialized experience include, but are not limited to: Conducting reviews to analyze the quality of completed rated cases Conducting evaluations and reviews on a quantitative or qualitative basis of claims development programs and operations to determine the effectiveness in meeting established goals and objectives. Preparing or conducting training activities. Identifying knowledge/skill gaps and plan training strategies. Providing and implementing data for one or more information management systems accurately and timely or providing technical guidance and direction to staff in the daily operation and maintenance of claims management systems. 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. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at http://://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/.

Education

There is no educational substitution at this grade level.

Contacts

• Address Seattle Regional Benefit Office 915 2nd Avenue Seattle, WA 98174 US
• Name: Katie Sherlock
• Email: [email protected]