The Credentialing Specialist has continuing responsibility for specialized duties to accomplish the mission and function of the credentials program at the VAMC. Serves as subject matter expert (SME) in the field of credentialing. Uses significant judgement to inform leadership and appropriate administrative staff of program changes, new regulatory requirements, policies and procedures or issues and concerns pertaining to the credentialing program.

Duties

Major duties include but are not limited to: Assists C&P Manager or Analyst in drafting local credentialing procedures for LIP and Non-LIPs. Receives and reviews correspondence and communications for the credentials function and determines which items require immediate attention and which are confidential in nature. Receives and reviews VetPro reports detecting problem areas requiring further investigation. Ensures primary source verification to include, but not limited to, state licenses, certifications, and required certifications. Assures application packages and other documents meet technical requirements per specialty of provider and assures application folder and database account (VetPro or other internal databases and spreadsheets) meet technical requirements. Communicates with Non-LIPs to assure timely completion of applications and VetPro requirements. Provides oversight to application process; analyzes exceptions and deviations in expected application process; determines course of action and makes recommendations. Determines processes for coordination of incoming data and documents from a variety of sources. Documents include, but are not limited to, VA applications for employment, primary source verifications of education and training, peer recommendations, licensure, certifications, NPDB single or NPDB Continuous Query (CQ) reports (Category 2 occupations) and personal history. Reviews documents and applications for omissions and inconsistencies and assures data entry is complete and accurate to meet VHA policy and regulation, and TJC standards. 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. Analyzes and manages issues related to documents that do not meet expected requirements, regulations or guidelines such as adverse actions against licensures, certifications, and NPDB) CQ reports. Independently selects appropriate method of validation, based on approved sources. As SME, may be requested to meet with surveyors such as TJC face to face to present non-LIP files and answer questions concerning the program. Manages the work involving the tracking of data and documents in support of the credentialing operation. Refers current issues, trends, problem areas as well as recommended program revisions to Credentials functions through the C&P Manager/Analyst. Conducts final appointment into the VetPro database, after thoroughly researching, analyzing and validating all data, information, documents and signature authorities. Delegated authority to initiate requests for information to the NPDB, and to respond to correspondence for requests for provider credentialing information from external entities in accordance with the System of Records Notice 77VA10E2E. Develops and provides routine and special reports as requested by the C&P Manager/Analyst. Composes correspondence requiring Clinical Service Chiefs and Medical Center Director signatures for credentialing actions. Maintains local VAMC requirement files and records pertaining to the credentialing process. 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. Provides quality control checks on data. Completes Mandatory Annual VetPro Security & Confidentiality training and Mandatory Annual Privacy Training. Uses appropriate safeguards to ensure provider confidentiality during the C&P process Meets the needs of customers, while supporting VA missions. Consistently communicates and treats internal and external customers in a courteous, tactful, and respectful manner. Provides the customer with consistent information according to 3 established policies and procedures. Handles conflict and problems in dealing with the customer constructively and appropriately. Performs other credentialing duties as assigned. Work Schedule: Monday - Friday 7:30am - 4:00pm Telework: Ad-hoc. Will be discussed during the interview process Virtual: This is not a virtual position. Position Description/PD#: Program Support Assistant (Credentialing Specialist)/PD99868S Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not Required

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 07/12/2024. 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-07 position you must have served 52 weeks at the GS-06. 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 described below: One (1) full year of specialized experience that equipped you with the the knowledge, skills, and abilities to successfully perform the duties the Program Support Assistant at the full performance level (GS-07), and that is typically in our related to the position to be filled. To be creditable, specialized experience must have been equivalent to at least the next lower grade level (GS-06) in Federal service. Specialized Experience Includes: Verifying of information in the health care provider files; maintaining confidentiality of information in accordance with the Privacy Act; provides quality control checks on data; managing multiple projects and priorities and meets deadlines; using software applications such as word processing and data bases and internet database applications for data entry, file maintenance and data retrieval; researching reference materials, regulations, and standards to identify appropriate action necessary to correct problems or issues. You will be rated on the following Competencies for this position: Attention to DetailClericalTechnical 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 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 is performed in an office setting which require normal safety precautions typical for offices and meeting rooms. The work area is adequately lighted, heated, and ventilated. 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

There is no educational substitution at this grade level.

Contacts

• Address VA Sierra Nevada Health Care System 975 Kirman Avenue Reno, NV 89502 US
• Name: Nicole Masters
• Phone: 2165444460
• Email: [email protected]