The incumbent serves as a Program Analyst - Clinic Profile Manager for the Department of Veterans Affairs, Veteran Health Administration. The Program Analyst - Clinic Profile Manager position provides a high level of complex and highly skilled support related to provider profile management. They coordinate clinical/provider profiles and scheduling grids, including but not limited to clinic set up and clinic maintenance.

Duties

This position reports to the Data Integration & Optimization Manager, within the Clinical Operations Service. The Incumbent is responsible for overall program management for the clinic maintenance process for the Facility and leads the facility's efforts to integrate profile management among healthcare providers, other facility staff, and patients. The clinic/provider profiles set up the clinic structure, allowing the scheduling of patients, direct workload capture, direct insurance and co-pay billing, direct MCA costing, and track facility and provider performance against national, Veterans Integrated Network (VISN), and local measures. The incumbent interprets national policies and procedures, developing and implementing local standards, defining requirements and providing advice to top management on related issues pertaining to clinic/provider profile management. Ensures that completed profiles reflect national, network and local goals, directives, and policies. Integrates advanced clinic access (ACA) principles and initiatives, outpatient scheduling directive mandates, ambulatory data capture and workload rules and regulations, coding and billing criteria, MCA requirements into clinic structures. Monitors and conducts annual reviews of accuracy of clinic profiles to ensure facility is capturing and transmitting workload accurately for maximum reimbursement, and workload credit. Works with services to monitor grid validation, appropriateness of Managerial Cost Accounting (MCA formerly DSS) identifiers, and count/non-count clinics, trains develops, coordinates and provides training to all areas impacting profile management and trains other staff to perform similar duties and will delegate duties, as needed. Coordinates all administrative needs of clinic profile building and maintenance, establishing the program goals, evaluating implementation, and data capture components for the Facility. Facilitates efficient and effective communication between Program Analysts (ADPAC)s, MCA, encounter form specialists, billing specialists, and assigned service. Participates in Facility/VISN projects, task forces, and committees to problem-solve, educate and implement software, data capture and scheduling directive matters, and other workgroups related to access, wait times, and clinic profile management. Represents the Facility at forums, conferences, and meetings. Delivers presentations to all levels of the Facility, service organizations, Veterans, family members and caregivers. Performs data retrieval and analysis for reports; prepares Facility reports to monitor accuracy and utilization regarding clinic profile management and communicates to appropriate Facility groups for action. Assumes overall responsibility for establishing and editing clinic changes, notifications, for new and established clinics and inactivating clinics in the system. Coordinates with informatics for development and management of data systems. Identifies problems and applies analytical techniques, correcting negative trends and provides resolutions to system issues/malfunctions, to include encounter and transmission errors, clinic grids and other issues related to clinic profile management. Updates and maintains digital workflow, forms, designs, and electronic records of clinic maintenance requests, such as creating new, modifications, inactivations and cancellations. Investigates complaints from internal and external customers related to clinic profile set up and resolves the complaint or escalates to the appropriate manager. Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level. This position involves a multi-grade career ladder. The major duties listed above represent the full performance level of GS-11. At the GS-09 grade level, you will perform assignments of a more limited scope and with less independence. You will progressively acquire the background necessary to perform at the full performance level of GS-11. Work Schedule: Monday - Friday 7:30 a.m. - 4:00 p.m. Telework: VA supports the use of telework as a way to help attract and retain talented individuals in public service, increase worker productivity, and better prepare the agency to operate during emergencies. This position is 100% telework. Virtual: This is not a virtual position. Position Description/PD#: Program Analyst (Clinic Profile Manager)/PD99898-S Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Authorized

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 11/19/2024. 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-09 position you must have served 52 weeks at the GS-07. For the GS-11 position, you must have served 52 weeks in the GS-09. 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. To qualify for this position, applicants must meet one of the following requirements: GS-9 Specialized Experience: Possess at least one year of specialized experience equivalent to at least the next lower grade GS-07 in the Federal service that has equipped me 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 a Program Analyst- Clinic Profile Manager. Qualifying specialized experience includes: Use of computer systems, entering and retrieval of data; Locating and interpreting applicable regulations; Use of medical records, medical billing programs, and medical terminology; Gathering, developing, and interpreting data from various information systems; and reviews reports, records, and provides statistical analysis for accuracy. NOTE: Experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. GS-11 Specialized Experience: Possess at least one year of specialized experience equivalent to at least the next lower grade GS-09 in the Federal service that has equipped me 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 a Program Analyst- Clinic Profile Manager. Qualifying specialized experience is: locating and interpreting applicable regulations dealing with care, policies, procedures, and precedents regarding scheduling, clinic profiles, ambulatory data capture, workload and billing; Knowledge of insurance intake processes and specialized medical billing programs; Reviewing data, presenting alternatives, making recommendations, and assisting with developing problem resolutions; Evaluate and analyze processes and procedures with multiple variables; and develop and implement training program, and ensure staff are properly educated and accountable for clinical profiles, scheduling, and data management. NOTE: Experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have: For the GS-09, to qualify based on education for this grade level you must have a master's or equivalent degree or two full years of progressively higher-level graduate education leading to such a degree orLL.B. or J.D., if related. Note: the work of the Program Analyst (Clinic Profile Manger) is sufficiently technical or specialized, therefore, graduate education alone may not provide the knowledge, and/or skill to perform the work. Course work must be related and clearly provides applicants with the background of knowledge and skills necessary for successful job performance. For the GS-11, to qualify based on education for this grade level you must have a Ph.D. or equivalent doctoral degree or three full years of progressively higher-level graduate education leading to a degree that is directly related to the position orLL.M., if related. 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. You will be rated on the following Competencies for this position: Administration and ManagementAnalytical ReasoningCommunicationData ManagementProject ManagementExperience 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: Regular and recurring work is mostly sedentary involving sitting at a desk, although the position requires the ability to move from one geographic location of the facility to another. The incumbent works with a computer screen and keyboard. Some physical effort such as standing, walking, bending or prolonged sitting may be required. The incumbent may be exposed to walking to outlying areas. The work places no special physical demands on the employee. 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 Tennessee Valley HCS - Nashville 1310 24th Avenue South Nashville, TN 37212 US
• Name: Davita Foushee Pugh
• Phone: 843-739-7502
• Email: [email protected]