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Are you looking for a Medical Management Specialist? We suggest you consider a direct vacancy at Veterans Health Administration in Hines. The page displays the terms, salary level, and employer contacts Veterans Health Administration person

Job opening: Medical Management Specialist

Salary: $54 728 - 87 024 per year
City: Hines
Published at: Jul 25 2024
Employment Type: Full-time
The Health Administrative Specialist on Duty (HOD) is a facility-wide position, located in the Office of the Chief, Patient Administration Service (PAS), or Business Office (BO), the position has both the authority and responsibility to represent both the Medical Center Director, and the Chief, HAS on all administrative matters occurring when assigned to other thank a normal tour of duty. Salary Ranges GS-7: $54,728 - $71,148 GS-9: $66,942 - $87,024

Duties

In this position, you will serve as Medical Management Specialist. Typical work assignments include: Interprets and applies VA rules and regulations relating to determining legal eligibility to benefits relating to hospital admission; fee basis; outpatient care; patient transfer; and beneficiary travel. Coordinates the resolution of medical-legal problems concerning the hospital. Processes administrative issues surrounding beneficiary death, seriously ill cases, elopements, suicides, assaults, death on arrival (DOA), homicides, code blue, cost recovery matters, and facility or community disaster, etc. Assumes control of communications and notifications in event of local and civil disasters, in accordance with local facility disaster plan. Provides orientation and situational technical advice to physicians regarding VA administrative policies and procedures. Assists hospital staff with medically related legal problems, including involuntary commitments, orders of protective custody, and management of unruly or severely disturbed patients. Coordinates non-routine contacts received at the hospital after regular business hours. Receives and responds to non-routine condition inquiries and other administrative inquiries from concerned families, Veterans, visitors, law enforcement officials, representatives from private hospitals, Veteran's service organizations representatives, VA Central Office, Congressional offices, unitary personnel, private physicians, media, and the public. Oversees determination of applicant's eligibility and determines extent of release of information or social data from patent's records. Guides PAS personnel assigned to the service during off tours and services as an advisory source for file room personnel, medical support and patient service assistants. Prepares daily gains and losses sheet and other related statistical reports. Provides written and oral reporting of incidents, beneficiaries, employees, as well as safety or other issues. Performs other related duties as assigned. Work Schedule: TOD will include rotating 2nd shift, 3rd shift, weekends, and holidays. Compressed/Flexible: As determined by the Agency Policy Virtual: This is not a virtual position. Position Description/PD#: Medical Management Specialist/PD99368S and PD99385S Relocation/Recruitment Incentives: Not Authorized Financial Disclosure Report: Not Required Travel Required: Occasional travel may be required as needed for this position.

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 08/02/2024. Must have Inpatient and Eligibility experience 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-05. For a GS-09 position you must have served 52 weeks at the GS-07. 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. You may qualify based on your experience and/or education as described below: Specialized Experience GS-7: Must possess at least one (1) full year of specialized experience that equipped the applicant with the particular knowledge, skill, and abilities to perform successfully the duties of the position and is typically in or related to the work of the position to be filled. To be creditable, specialized experience must have been equivalent to at least the next lower grade level in the normal line of progression for the occupation in the organization (GS-5). Specialized experience is defined as: Experience in positions that required an ability to maintain continuity of functions and provide medical administrative support to clinical personnel; knowledge of VA regulations and laws governing medical benefits and release of medical information; skill in the use of automated systems such as the electronic patient record, patient registration, etc.; skill in the use of automated systems such as Microsoft Word, Excel, Access programs, and web-based systems; knowledge of medical and technical terminology; knowledge of VA benefits and ability to determine veteran eligibility; and skill in communication and interpersonal relations, including the ability to appropriately and courteously relate internal and external customers. --OR-- Education GS-7: Successful completion of 1 full year of graduate level education; --or-- have completed a 4-year course of study leading to a bachelor's degree in any field and have superior academic achievement (S.A.A). S.A.A. is based on (a) graduated in the top third of class. Class is defined as the college, university, or major subdivision, such as the College of Liberal Arts or the School of Business Administration. (b) Graduated with a Grade-point average of 2.95 or higher out of a possible 4.0. This grade point average could have been determined based on 4 years of education or based on courses completed during the final 2 years of the curriculum. (c) Graduated with a grade-point average of 3.45 or higher out of a possible 4.0 based on courses required for my major field or courses in the major field completed during the final 2 years of the curriculum. (d) Member of a national scholastic honor society. TRANSCRIPTS REQUIRED. --OR-- Combination Education and Specialized Experience GS-7: Applicants may also combine education and experience to qualify at the GS-7 level. To calculate, first identify the percentage of required education you have earned (when substituting, you cannot use the first 60 semester hours that you earned). Then identify the percentage of required experience you possess. Add the two percentages. The total percentage must equal at least 100 percent to qualify at the GS-7. For example, an applicant who has 9 semester hours of graduate level education (i.e. 50% of graduate education required) and 6 months of creditable specialized experience (i.e. 50% of the required experience) would equal 100% of the required experience for the position. TRANSCRIPTS REQUIRED. Specialized Experience GS-9: At least one (1) full year of experience equivalent to the GS-7 level. Specialized experience is defined as experience that equipped the applicant 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 the position to be filled. For this position, specialized experience consists of: Working knowledge of applicable public laws, federal and policies and regulations, station directives, legal decisions, and state laws dealing with care and treatment of veterans and beneficiaries; ability to interpret rules, regulations, policies, and procedures to make sound decisions, using good judgment; working knowledge of medical and administrative records systems to determine eligibility, register/admit patients, schedule/adjust tours of duty for staffing purposes, and to retrieve information and prepare reports; knowledge of safety and fire prevention rules and regulations, of facility and community disaster plans and procedures; knowledge of medical and technical terminology and the functions of specialty departments and divisions within a medical center; ability to cope with problems and initiate resolution while working independently and with minimal or no supervision. OR Substitution of Education for Experience: Masters or equivalent graduate degree, or successful completion of two (2) years of progressively higher-level graduate education leading to such a degree, or LL.B or J.D., if related, obtained in an accredited college or university, may be substituted to qualify for the grade 9, Medical Administration Specialist position. One year of full-time graduate education is considered to be the number of credit hours that the school attended has determined to represent one (1) year of full-time study. If that number cannot be obtained from the school, 18 semester hours will be considered an academic year of graduate study. Part-time graduate education is creditable in accordance with its relationship to a year of full-time study at the school attended. NOTE: TRANSCRIPTS REQUIRED. OR Combination Education and Experience: Equivalent combinations of successfully completed graduate education and specialized experience directly related to the work of the Medical Administration Specialist position, which may be substituted to meet the experience requirements of the position. For example, 6 months of appropriate specialized experience equivalent to GS-07 (50 percent of the experience requirement for GS-9) and 1 year of successfully completed graduate education (18 semester hours), as is describe above, (50 percent of the education requirement for the GS-9) would qualify for a GS-9 position. NOTE: TRANSCRIPTS REQUIRED. Physical Requirements: The work requires much walking through the hospital with occasionally the requirement to lift objects such as suitcases, clothing, or medical charts. 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. 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 Edward Hines Junior Hospital 5000 South 5th Avenue Hines, IL 60141 US
  • Name: Cosby Johnson
  • Phone: 515-323-7575 X3239
  • Email: [email protected]

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