The Health System Specialist -Credentialing and Privileging Specialist is assigned to the Medical Staff Office, which is under the Chief of Staff at a VA Medical Center (VAMC) and is responsible for providing administrative and technical direction and support to the credentialing and privileging (C&P) operations.

Duties

The C&P Specialist is aligned to and supervised by the C&P Manager. The incumbent 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. Major duties include, but are not limited to: Performing as the subject matter expert (SME) to Licensed Independent Providers (LIPs) and Service Chiefs regarding routine and complex matters related to C&P. Assisting the C&P Manager/Analyst in developing short- and long-term goals necessary to accomplish the mission of the C&P program. Assisting the C&P Manager/Analyst in drafting local credentialing processes and Medical Staff Bylaws in compliance with all applicable regulations. Receiving and reviewing VetPro reports detecting problem areas requiring further investigation. Informing the C&P Manager/Analyst of trends identified, audit results and identified problems that may affect a provider's privilege status. Providing guidance and instruction to hospital staff in completing the required documentation of establishing privileges for LIPs. Assuring 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. Serving as technical advisor to the Executive Committee of the Medical Staff (ECMS) and if applicable the Credentials Committee. Developing and providing routine and special reports as requested by the C&P Manager/Analyst. Establishing and maintains a variety of files and records pertaining to the C&P process. 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. Work Schedule: Monday - Friday; 7:30 a.m. - 4:00 p.m. Telework: Available Virtual: This is not a virtual position. Position Description/PD#: Health System Specialist (Credentialing and Privileging)/PD99876S Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Physical Requirements and Work Environment: 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. The work is performed in an office setting which require normal safety precautions typical for offices and meeting rooms. The work area is adequately lighted, heated, and ventilated.

Requirements

Qualifications

To qualify for this position, applicants must meet time in grade and specialized experience requirements within 30 days of the closing date of this announcement, 11/25/2024. 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 within 30 days of 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. To qualify for this position at the GS-7 level, you must meet one of the following: Specialized Experience: You must have at least one (1) full year of specialized experience, equivalent to the next lower grade level (GS-5) in Federal Service, that equipped you with the particular knowledge, skills, and abilities to successfully perform the duties of a Health System Specialist - Credentialing and Privileging Specialist at a developmental level, and that is typically in or related to the work of the position to be filled. Your experience must show 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: (1) Missions, organizations, programs, and requirements of health care delivery systems; (2) Regulations and standards of various regulatory and credentialing groups; and (3) Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement. Examples of specialized experience would typically include, but is not limited to: Knowledge of medical terminology, medical specialties and core privileges and procedures to assure competence/appropriateness of credentials and privileging requested; Skill in using software applications such as word processing and data bases and internet database applications for data entry, file maintenance and data retrieval and analysis; Attention to detail required; Ability to communicate orally technical information to a diverse group of individuals with varying levels of understanding. Knowledge of the contacts required for verification of information in health care provider files. 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: PLEASE SEE EDUATION FOR DETAILS ~OR~ Combination: PLEASE SEE EDUATION FOR DETAILS ~OR~ Superior Academic Achievement (SAA): PLEASE SEE EDUATION FOR DETAILS To qualify for this position at the GS-9 level, you must meet one of the following: Specialized Experience: You must have at least one (1) full year of specialized experience, equivalent to the next lower grade level (GS-7) in Federal Service, that equipped you with the particular knowledge, skills, and abilities to successfully perform the duties of a Health System Specialist - Credentialing and Privileging, and includes performing duties associated with healthcare credentialing and privileging. Your experience must show 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: (1) Missions, organizations, programs, and requirements of health care delivery systems; (2) Regulations and standards of various regulatory and credentialing groups; and (3) Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement. Examples of specialized experience would typically include, but is not limited to: Broad and thorough knowledge of pertinent laws, regulations, policies and precedents, accreditation standards and guidelines such as TJC; Comprehensive knowledge of VetPro policies, including but not limited to, VetPro Data Integrity, Facility level access control, mandatory annual VetPro security and confidentiality training, and mandatory annual privacy act training; Skill in applying analytical and evaluative methods and techniques to issues or studies concerning the efficiency and effectiveness of the C&P operations, such as advising leadership on documentation requirements for provider profiling and competence. Ability to manage multiple projects and priorities and meet deadlines. 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: PLEASE SEE EDUATION FOR DETAILS ~OR~ Combination: PLEASE SEE EDUATION FOR DETAILS You will be rated on the following Competencies for this position: CommunicationsComplianceQuality AssuranceTechnical Competence 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. 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. 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/.

GS-07 -

Education: Successful completion of one (1) full year of graduate education. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work of this position (i.e., hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration). NOTE: Copies of transcripts must be submitted with your application materials. Education cannot be credited without documentation.
~OR~
Combination: Combinations of successfully completed graduate level education and specialized experience, as described above, to meet the total requirements. The education portion must include graduate courses that demonstrate the knowledge, skills, and abilities necessary to do the work of this position (i.e. hospital administration, public health administration, or related fields such as course work in health care administration). Only education beyond a bachelor's degree may be used to qualify applicants for the GS-07 level. NOTE: Copies of transcripts must be submitted with your application materials. Education cannot be credited without documentation.
~OR~
Superior Academic Achievement (SAA): SAA at the baccalaureate level in the coursework detailed above is fully qualifying. Applicants who wish to apply under this provision must submit proof from their educational institution that they meet one of the criteria listed below. To qualify for SAA, applicants must have completed all the requirements for a bachelor's degree in a curriculum that is qualifying for the position to be filled and meet one of the following:

• Rank in the upper one-third of your class in the college, university or major subdivision.
• A grade-point average of "B" (a GPA of 2.95 or higher out of a possible 4.0) for all completed undergraduate courses, or those completed in the last two years of undergraduate study.
• A grade point average of "B+" (a GPA of 3.45 or higher out of a possible 4.0) for all courses in your major field of study, or those courses in your major completed in the last two years of undergraduate study.
• Membership in a national honor society (other than freshman honor societies) recognized by the Association of College Honor Societies. For a list of recognized honor societies please visit http://www.achsnatl.org/quick_link.asp.

For more information regarding SAA please visit http://www.opm.gov/qualifications/SEC-II/s2-e5.asp#e4f.

GS-09 -

Education: Successful completion of a master's or equivalent graduate degree, successfully completed two (2) full years of progressively higher level graduate education leading to such a degree, LL.B or J.D. if related. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work of this position (i.e., hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration). NOTE: Copies of transcripts must be submitted with your application materials. Education cannot be credited without documentation.
~OR~
Combination: Combinations of successfully completed graduate level education (beyond the first year) and specialized experience, as described above, to meet the total requirements. The education portion must include graduate courses that demonstrate the knowledge, skills, and abilities necessary to do to the work of this position (i.e. hospital administration, public health administration, or related fields such as course work in health care administration). NOTE: Copies of transcripts must be submitted with your application materials. Education cannot be credited without documentation.

Contacts

• Address Boise VA Medical Center 500 West Fort Street Boise, ID 83702 US
• Name: Simone Ball
• Phone: 541-440-1000 X44275
• Email: [email protected]