This position is assigned to the Office of the Director, Command Suite, located at the Captain James A. Lovell Federal Health Care Center (FHCC), North Chicago, Illinois

Duties

MAJOR DUTIES: - Performs functions associated with the initial and continued development and oversight of the facility Integrity and Compliance Program -Collaborates with the facility Integrity and Compliance Officer (ICO) in planning, developing, and implementing programs to effectively identify, plan, assess, respond, and monitor areas of high risk, and coordinate efforts to improve performance as deemed necessary while performing VHA and other mandated audits and reviews of compliance program areas. -Provide audits and analyses of data entered into clinical systems, including but not limited to CPT codes, encounter documentation, enrollment data, means testing and workload -Provides educational assistance to facility staff under the direction of the Integrity and Compliance Officer. -Developing and reviewing procedures and methodologies to ensure accuracy of reimbursement, insurance information, enrollment reliability and other compliance related data, -Providing answers to difficult technical questions regarding coding and analysis and resolve coding discrepancies. -Providing feedback to physicians and staff concerning medical record documentation -Serving as technical advisor and resource person and/or liaison with the medical staff on questions relating to medical record documentation, coding, enrollment, insurance, means testing and reimbursement issues - Compiles and maintains appropriate management reports and committee minutes -Assists in maintaining good communications between the OIC Office and VA staff - Provides technical assistance to the ICO in the selection of focused audits, criteria development, data retrieval, compilation of findings, and follow-up audits oriented toward improved utilization of resources including cost effectiveness - Continues education to keep abreast of new developments and policy changes that affect the Integrity and Compliance Program and recommends revisions of the technical aspects of these programs to meet these new demands. - Provides staff support to the Integrity and Compliance Committee and Command Suite. - Participates in discussions, develops agenda content for recurring meetings and prepares meeting minutes. - Creates communication processes and tools that are flexible, customizable, and interactive to address the health care system's unique compliance challenges and education/training needs. Work Schedule: Monday-Friday 7:00am -3:30pm 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. Position Description/PD#: Health System Specialist (Integrity and Compliance Auditor)/PD99744-S

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 05/29/2024. 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 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. You may qualify based on your experience and/or education as described below: Specialized Experience: At least one (1) full year of specialized experience equivalent to at least the next lower grade level (GS-9) in the Federal Service that has given you the particular knowledge, skills and abilities required to successfully perform the duties of this position. Specialized experience includes: lead or supervisory experience such as directing the work of subordinates, managing performance, handling employee complaints, reviewing training needs, etc.; experience assisting with a variety of management services essential to the operation of a program or office/organization; has a working knowledge of budget/fiscal management and human resources/personnel management; ensuring compliance with established policies, practices and procedures; and communicating and collaborating with individuals with varied backgrounds and different situations. NOTE: Experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. OR, Education: Successful completion of a Ph.D. or equivalent doctoral degree or 3 full years of progressively higher-level graduate education leading to such a degree, from an accredited college or university. Such education must demonstrate the knowledge, skills and abilities necessary to do the work of this position. NOTE: Transcripts (unofficial or official) must be submitted with your application materials. Education cannot be credited without documentation. OR, Combination: Equivalent combination of successfully completed graduate level education (beyond the second year) and specialized experience, as described above, which may be used to meet total experience requirements for this grade level. The education portion must include graduate courses that demonstrate the knowledge, skills and abilities necessary to do the work of position and must have been obtained in an accredited college or university. NOTE: Transcripts (unofficial or official) must be submitted with your application materials. Education cannot be credited without documentation . You will be rated on the following Competencies for this position: Interpersonal SkillsNegotiationPlanning and EvaluatingProject ManagementReasoningTechnical Competence 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 regular and recurring work of this position is mostly sedentary and involves sitting at a desk and working with a computer screen and keyboard. The position requires the ability to move from one geographic location of the facility to another and walking, standing, bending, climbing stairs, and carrying some light items. Stamina and concentration to meet crucial deadlines is required. The work is performed in a typical office setting, possibly shared office. The office will be within the physical structure of the hospital or one of its surrounding structures as well as Community Based Outpatient Clinics. The work area is usually adequately lighted, heated, and ventilated. This position is eligible for telework. 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 Captain James A Lovell Federal Health Care Center 3001 Green Bay Road North Chicago, IL 60064 US
• Name: Brianna Turner
• Phone: 708-904-8377
• Email: [email protected]