About the Position: This position is in the TRICARE Operations Department, Health Care Business Directorate, Naval Hospital, Jacksonville, Florida. The purpose of this position is to document, manage and track all referrals and Clear and Legible Reports (CLRs). A recruitment or relocation incentive may be authorized. Salary negotiation may be available for those candidates who are new to Federal service. Student Loan repayment may be authorized. Advance leave accrual may be authorized.

Duties

Complies with Joint Commission requirements and Defense Health Agency's (DHA) policies governing referral management processes and business rules governing the CLR process. Utilizing a variety of internal and external resources, research, documents and tracks referrals in a referral tracking database. Ensures steps to enter, review and close out CLRs are completed, ensuring CLRs are posted to the correct beneficiary's record. Researches and identifies network referrals, Managed Care Support Contractor (MCSC) authorizations and beneficiary claims to match CLRs with the appropriate specialty and referral. Uploads CLRs into the appropriate beneficiary's electronic health record and notifies MTF provider of receipt in accordance with current DHA guidelines. Research MTF referrals and identifies corresponding MCSC authorizations to provide information and assist beneficiaries with obtaining medical care. Reports to the supervisor observed workplace hazards, injuries, occupational illnesses or property damage resulting from accidents. Performs other duties as assigned.

Requirements

• Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation.
• This position requires the incumbent be able to obtain and maintain a determination of eligibility for a Secret security clearance or access for the duration of employment. A background investigation and credit check are required.
• Selectees will be required to sign a statement (Condition of Employment) consenting to seasonal influenza vaccinations or must provide a recognized exemption.
• This position requires a qualified typist.

Qualifications

Who May Apply: Only applicants who meet one of the employment authority categories below are eligible to apply for this job. You will be asked to identify which category or categories you meet, and to provide documents which prove you meet the category or categories you selected. 30 Percent or More Disabled VeteransCurrent Civilian Employees of the Defense Health Agency (DHA)Current Permanent Department of Defense (DoD) Civilian EmployeeDomestic Defense Industrial Base/Major Range and Test Facilities Base Civilian Personnel WorkforceInteragency Career Transition Assistance PlanLand Management Workforce Flexibility ActMilitary Spouses, under Executive Order (E.O.) 13473Non-Department of Defense (DoD) TransferPeople with Disabilities, Schedule APriority Placement Program, DoD Military Spouse Preference (MSP) EligibleReinstatementVeterans Employment Opportunity Act (VEOA) of 1998Veterans Recruitment Appointment (VRA) In order to qualify, you must meet the education and/or experience requirements described below. 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; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document. Specialized Experience: One year of specialized experience which includes performing any of the following tasks: assisting with referral processes using automated systems; answering phone calls; and/or maintaining files and documentation using a filing system. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-04). OR Education: Four years of education above the high school level obtained in an accredited business, secretarial or technical school, junior college, college or university. OR Combination of Education and Experience: A combination of education and experience may be used to qualify for this position as long as the computed percentage of the requirements is at least 100%. To compute the percentage of the requirements, divide your total months of experience by 12. Then divide your semester hours of education beyond two years (total semester hours minus 60) by 60. Add the two percentages. Proficiency Required:This position requires a qualified typist. A qualified typist can type 40 words per minute based on a 5 minute sample with three or fewer errors. You will be evaluated on the basis of your level of competency in the following areas: Customer Service (Clerical/Technical)Decision MakingManages and Organizes InformationTechnical Competence Time in Grade Requirement: Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-04).

Education

FOREIGN EDUCATION: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications.

Contacts

• Address JT-DHA-DDAAFL DHA JACKSONVILLE MKT-JACKSONVILLE DO NOT MAIL Jacksonville, FL 32214 US
• Name: Army Applicant Help Desk