The Health System Specialist - Credentialing and Privileging Specialist is assigned to the Medical Staff Office, which is under the Chief of Staff at the VA Northern California Health Care System and is responsible for providing administrative and technical direction and support to the credentialing and privileging (C&P) operations. The C&P Specialist is aligned to and supervised by the C&P Manager. This is a developmental position. This is a non bargaining unit position.

Duties

The Credentialing & Privileging Specialist ensures compliance with VHA policies, directives, memos and notices of The Joint Commission (TJC) standards, recommendations by the Office of Inspector General (OIG) and Government Accountability Office (GAO) and other internal or external auditors and reviewers as appropriate. The incumbent is responsible for collecting relevant data and making informed decisions to ensure qualified health care professionals are providing appropriate care in appropriate settings. The incumbent is the subject matter expert (SME) to LIPs and Service Chiefs regarding routine and complex matters related to C&P including provider competence for the ongoing provider practice evaluation (OPPE) and focused provider practice evaluation (FPPE). The functions of the Medical Staff Office are critical to patient safety and for assuring the quality of patient care provided by the VAMC. Major duties include, but are not limited to: Assists the C&P Manager/Analyst in developing short- and long-term goals necessary to accomplish the mission of the C&P program. Assists in identifying the resources necessary for accomplishing the mission and function of the credentials and privileging program. Receives and reviews VetPro reports detecting problem areas requiring further investigation. Upon identification of a problem, researches reference materials, regulations, and standards to identify appropriate action necessary to correct the problem. Ensures accurate provider data is entered into and maintained in the VetPro computer program. Informs C&P Manager/Analyst of trends identified, audit results and identified problems that may affect a provider's privilege status. Manages provider applications (initial and renewals) for LIPs C&P within the VAMC. Provides guidance and instruction to hospital staff in completing the required documentation of establishing privileges for LIPs. Upon receipt of individual credentials' files for review, incumbent ensures primary source verification to include, but not limited to, state licenses, DEA license, certifications, medical specialty training, and board 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. Prepares agendas for credentials related meetings, ensures those involved are notified of expectations, and ensures appropriate paperwork is accomplished completely and accurately prepared for committee action. Conducts final appointment into the VetPro database, after thoroughly researching, analyzing and validating all data, information, documents and signature authorities. Composes correspondence requiring Clinical Service Chiefs, Chief of Staff and Medical Center Director signatures for privileging actions. Establishes and maintains a variety of files and records pertaining to the C&P process. Holds the credit card and is responsible for maintaining records, reconciling monthly charge statements and verifying legitimacy of requests for NPDB CQ enrollments/ renewals, licensure verification (if applicable), Educational Commission for Foreign Medical Graduates , American Medical Association, FSMB, National Student Clearing House, Work Number and, board certification (if applicable). Initiates electronic requests and bank checks for payment of fees according to standard operating procedures as needed. Work Schedule: Monday through Friday 8:00 Am to 4:30 PM Telework: Not available Virtual: This is not a virtual position. Position Description/PD#: Health System Specialist (Credentialing and Privileging Specialist)/PD99876S Relocation/Recruitment Incentives: Not authorized Financial Disclosure Report: Not required

Requirements

• You must be a U.S. citizen to apply for this job
• Subject to a background/suitability investigation
• Designated and/or random drug testing may be required
• May serve a probationary period
• Selective Service Registration is required for males born after 12/31/1959
• A complete application package; Resume, Transcripts, etc.
• Selected applicants will be required to complete an online onboarding process

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 09/06/2024. You may qualify based on your experience and/or education as described below: Individual Occupational Requirement (IOR): The 0671 series requires specific education or experience to be met in order to be appointed into a position of this series. You must meet one of the pre-determined Education or Experience Individual Occupational Requirements listed below as set by Office of Personnel Management (OPM). Undergraduate and Graduate education: Major study -- hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. OR, Specialized Experience: Progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care field. This work may have been performed in an operating health care facility or a higher organizational echelon with advisory or directional authority over such facilities. Work must have involved a close working relationship with facility managers and analysis and/or coordination of administrative, clinical, or other service activities, and provided knowledge of the following: Missions, organizations, programs, and requirements of health care delivery systems; Regulations and standards of various regulatory and credentialing groups; and Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement. OR, Special Provision for In-service Placement: Successful completion of an agency-sponsored on-the-job training program may be substituted for qualifying experience, provided it included a formal individualized training plan. Such a training program must have been conducted in an operating health care system and included: Assignments providing a knowledge of basic health system administration philosophies, practices, and procedures, and basic government administrative policies and requirements; Practical assignments providing an opportunity to apply health system administration skills and principles (as the individual progresses, work assignments must be characteristic of the grade level to which he or she is assigned); and Oversight by an experienced health system administrator with periodic evaluation of the individual's progress and appropriate adjustment of the training program. 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-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. 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. GS-7 Grade Level requirements: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-5 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: perform highly structured, entry-level work designed to develop broader and more in depth knowledge and skill to perform higher-level assignments, communicate factual and procedural information clearly, orally and in writing, gather and analyze basic facts and draw conclusions. OR Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have 1 full year of graduation education or superior academic achievement. OR Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond Graduate level. GS-9 Grade Level requirements: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-07 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Using software applications such as word processing and data bases and internet database applications for data entry, file maintenance and data retrieval and analysis. Working with medical staff to ensure accreditation standards are met. Providing support to a credentialing and privileging program. Progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care field. This work may have been performed in an operating health care facility or a higher organizational echelon with advisory or directional authority over such facilities. Work must have involved a close working relationship with facility managers and analysis and/or coordination of administrative, clinical, or other service activities, and provided knowledge of the following: Missions, organizations, programs, and requirements of health care delivery systems; Regulations and standards of various regulatory and credentialing groups; and Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement.. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree with a major study in hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. OR, Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond the first full year of graduate education. You will be rated on the following Competencies for this position: CommunicationsComplianceQuality AssuranceTechnical Competence 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. 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: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.

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.

Contacts

• Address VA Northern California Health Care System 10535 Hospital Way Mather, CA 95655 US
• Name: Sydnee Holmes
• Phone: 504-635-8084
• Email: [email protected]