The Health System Specialist for Purchased Referred Care (PRC) is located at the Ft. Yuma Service Unit. The specialist performs assigned program activities and functions related to PRC requirements. Such activities include analyzing, evaluating, advising, and coordinating PRC and alternate resources operations. This position reports to the Supervisory Health System Specialist.

Duties

Reviews and provides analysis of health data submitted and compiled from various programs to assure accuracy and completeness. Provides guidance and instruction to originators on information requirements, changes in processing methods, and proper reporting procedures. Makes determination as to patient eligibility, scope, and priority for the PRC program. Responds to inquiries and requests for PRC assistance made to the Service Unit Director. Accountable for the maintenance and control of Service Unit PRC funds for medical services. Compiles statistical and fiscal data necessary to determine funds required to meet the needs of the PRC program for the Service Unit. Performs periodic spot reviews and audits of completed authorization forms and other documents to insure consistent and correct use of allotment, object, sub-object, and sub-activity coding required by financial management practices. Implements and directs the patient database information system which includes conducting patient interviews to obtain information on demographic and alternate resources data, recording the information and submitting for alternate resources reimbursement.

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. For positions requiring positive education requirements, or if you are using education to meet all or part of the qualification requirements, you MUST submit a copy of your transcripts or an itemized list of college courses which includes equivalent information from the transcript (course title, semester/quarter hours, and grade/degree earned) in your resume. INDIVIDUAL OCCUPATIONAL REQUIREMENTS: 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. Special Provision for Inservice 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. In addition to the Individual Occupational Requirements, you must also meet the Minimum Qualifications stated below. MINIMUM QUALIFICATIONS, GS-0671-09: At least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Examples of experience include: Reviews and provides analysis of health data submitted; compiled from various programs to assure accuracy and completeness; compiles statistical and fiscal data necessary to determine funds required to meet the needs of the program. OR Completion of requirements for a Master's or equivalent graduate degree; or two full years progressively higher level graduate education leading to such a degree. OR Posses a combination of education and experience that when combined fully meet the minimum qualifications for this position. The total percentage equals at least 100 percent to qualify for this GS-09 grade level. 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. 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).

Education

When there is a positive education requirement, or you are using education to qualify as a substitution for experience, transcripts (unofficial) are required at the time of application to verify that you meet the educational requirement or substitution.
Only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education may be credited. Applicants can verify accreditation at the following website: https://www.ed.gov/accreditation

Foreign Education: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show that 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://www2.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.

Contacts

• Address Fort Yuma Service Unit 401 E. Picacho Road Winterhaven, CA 92283 US
• Name: Phoenix Area IHS Human Resources
• Email: [email protected]