This position is located at the Whiteriver Service Unit, Purchased Referred Care (PRC), Phoenix Area Indian Health Service. The purpose of this position is to provide technical and administrative assistance in the management and administration of the Purchased Referred Care (PRC) Program. This position will report to the Supervisory Health System Specialist or Designee, on-site.

Duties

Determine eligibility of patients for PRC and prepare authorization or denial documents based on applicable PRC regulations, policies and practices. Prepare referrals with correct patient information, medical report and calculated estimates charges of medical care and equipment for review by Purchased Referred Care Committee. Functions in a liaison capacity to both vendors and recipients of PRC by telephone and through written correspondence. Screens verifies and determines all Purchased Referred Care notifications, claims, statement of private vendors, emergency room notes and patient discharge summaries. Explains and interprets regulations and policies to health service providers and recipients as well as IHS personnel. Ensures and maintains internal fiscal controls; and billing and collection procedures on funds being obligated or collected.

Requirements

Qualifications

To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying. 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; religious; spiritual; community; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week. MINIMUM QUALIFICATIONS, GS-06: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Examples include: apply patient referred/care procedures and regulations, work with funding limitations and policies, technical, administrative and clerical functions related to the patient referral program; proper processing requirements including forms, authorization documents, correspondence and reports; Maintain obligation registers regarding funds for medical services. MINIMUM QUALIFICATIONS, GS-07: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-06 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Examples include: Apply policies, procedures, rules and regulations when determining patient eligibility, availability of services and identification of fiscal resources; Manage funds control techniques to account for allotted funds and preparing statements and reports; operate an automated data program system for patient referral reporting, funds control techniques. Time In Grade Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP). You must meet all qualification requirements within 30 days of the closing date of the announcement.

Contacts

• Address White River Service Unit PO Box 860 White River, AZ 85941 US
• Name: Jenny Vasquez
• Email: [email protected]