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Job opening: Health System Specialist (Credentialing & Privileging)

Salary: $54 896 - 87 291 per year
City: Seattle
Published at: Apr 08 2024
Employment Type: Full-time
The Health System Specialist (C&P Specialist) is assigned to the Medical Staff Office, which is under the Chief of Staff at VA Puget Sound Healthcare System (VAPSHCS) and is responsible for providing administrative and technical direction and support to the credentialing and privileging (C&P) operations; ensuring compliance with VHA policies, directives, memos and notices. This is a full time position at 40 hours per week.

Duties

Major duties include but are not limited to: Assists the C&P Manager or Analyst in developing short- and long-term goals necessary to accomplish the mission of the C&P program. Assists in identifying the resources necessary for accomplishing the mission and function of the credentials and privileging program. Serves as Subject Matter Expert in the field of credentials and clinical privileging. Keeps leadership and appropriate administrative staff informed of program changes, new regulatory requirements, and policies and procedures pertaining to the C&P process. Assists C&P Manager/Analyst in drafting 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. Receives and reviews reports detecting problem areas requiring further investigation. Ensures accurate provider data is entered into and maintained in the credentialing and privileging system database. Ensures current information is present on providers relative 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, initial and renewal of privileges which may affect the status of privileges granted for medical practice. Informs C&P Manager/Analyst of trends identified, audit results and identified problems that may affect a provider's privilege status Coordinates with clinical service departments on findings of clinical care competency. Assures application packages and other documents meet technical requirements per specialty of provider and assures application folder and database account meet technical requirements. Provides oversight to application process; analyzes exceptions and deviations in expected application process; determines course of action and makes recommendations. Reviews documents received and determines course of action based on information provided within documents. Contacts provider for omissions and/or inconsistencies in information; initiates primary source verification of credentials. Coordinates incoming data from a variety of sources; establishes protocols for incoming data; organizes computerized data sets; and retrieves computerized data. Creates automated system of program-specific data to track suspense's on items such as project milestones, progress reports, and compliance strategies. Prepares agendas for credentials related meetings, ensures those involved are notified of expectations, and ensures appropriate paperwork is accomplished completely and accurately prepared for committee action. Documents details of privileging actions, both routine and adverse, in detail with accuracy necessary for defending appeals to higher authority. Monitors and ensures suspense's are met in the time sensitive actions for privileges modification, biennial renewals, temporary limitations or suspensions, and any other time-limited privileging action. Conducts final appointment into the credentialing and privileging system database, after thoroughly researching, analyzing and validating all data, information, documents and signature authorities. Maintains confidentiality of information in accordance with the Privacy Act in releasing information. Manages, administers and assures accuracy, security and maintenance of operations of database systems. Reviews quality assessment findings, risk management evaluations and malpractice claim actions to ensure appropriate coordination with the credentials and privileging function of the credentials committee of the medical staff regarding individual provider clinical privileges. 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. Selection at a lower grade level does not guarantee promotion to the full performance level. Work Schedule: M-F 0800-1630 (otherwise communicated upon hire) Compressed/Flexible: Negotiable upon hire Telework: Upon completion of probationary period and/or satisfactory evaluation as determined by agency policy Virtual: This is not a virtual position. Position Description/PD#: Health System Specialist (Credentialing & Privileging)/PD99876A and PD99876S Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not authorized Financial Disclosure Report: Not required

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements within 30 days of the closing date of this announcement, 04/25/2024. 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. ` 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. This occupation series has an Individual Occupation Requirement that must be met by all applicant regardless of grade level: Undergraduate and Graduate Education: Major study -- hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. Preferred Experience: Uses computers, software applications, databases, and automated systems to accomplish work GS-07 MINIMUM QUALIFICATIONS: SPECIALIZED EXPERIENCE: Must have at least one (1) full year of specialized experience equivalent to the GS-5 level in the Federal service that has equipped me with the particular knowledge, skills, and abilities to perform successfully the duties of the position, and that is typically in or related to the work of this Health System Specialist position. Qualifying specialized experience is defined as 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: (1) Missions, organizations, programs, and requirements of health care delivery systems; (2) Regulations andstandards of various regulatory andcredentialing groups; and (3) Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement; OR, EDUCATION: Must have completed one (1) full year of graduate education. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work of this position (i.e., 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 have been obtained in an accredited college or university and must demonstrate the knowledge, skills, and abilities necessary to do the work of this position; OR, COMBINATION OF EDUCATION AND EXPERIENCE: Must have an equivalent combination of successfully completed graduate level education and specialized experience, as described above, to meet the total requirements. The education portion must include graduate courses that demonstrate the knowledge, skills, and abilities necessary to do to the work of this position (i.e. hospital administration, public health administration, or related fields such as course work in health care administration). Only education beyond a bachelor's degree may be used to qualify applicants for the GS-07 level. This education must have been obtained in an accredited college or university; OR, SUPERIOR ACADEMIC ACHIEVEMENT (SAA): Must have completed all the requirements for a bachelor's degree in a curriculum that is qualifying (i.e. hospital administration, public health administration, or related fields such as course work in health care administration) for the position to be filled and I meet one of the following: Rank in the upper one-third of your class in the college, university or major subdivision; A grade-point average of "B" (a GPA of 2.95 or higher out of a possible 4.0) for all completed undergraduate courses, or those completed in the last two years of undergraduate study; A grade point average of "B+" (a GPA of 3.45 or higher out of a possible 4.0) for all courses in your major field of study, or those courses in your major completed in the last two years of undergraduate study; and Membership in a national honor society (other than freshman honor societies) recognized by the Association of College Honor Societies. For a list of recognized honor societies please visit http://www.achsnatl.org/quick_link.asp. GS-9 MINIMUM QUALIFICATIONS: SPECIALIZED EXPERIENCE: Must have at least one (1) full year of specialized experience equivalent to the GS-7 level in the Federal service that has equipped me with the particular knowledge, skills, and abilities to perform successfully the duties of the position, and that is typically in or related to the work of this Health System Specialist position. Qualifying specialized experience is defined as 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: (1) Missions, organizations, programs, and requirements of health care delivery systems; (2) Regulations and standards of various regulatory and credentialing groups; and (3) Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement; OR, EDUCATION SUBSTITUTION: Must have successfully completed a master's or equivalent graduate degree or successfully completed two (2) full years of progressively higher-level graduate education leading to such a degree. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work of this position (i.e., hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration). The education portion must include courses that demonstrate the knowledge, skills, and abilities necessary to do the work of this position. Education must have been obtained in an accredited college, or university; OR, COMBINATION: Musthave an equivalent combination of successfully completed education and specialized experience directly related to the work of the position as outlined above that meets the requirements of the position. Only education more than the first year (18 semester hours) may be used to qualify applicants for the GS-09 level.

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 VA Puget Sound Health Care System 1660 South Columbian Way Seattle, WA 98108 US
  • Name: Denise Lindsey
  • Phone: 916-776-0180
  • Email: [email protected]

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