Job opening: Health System Specialist (Credentialing & Privileging Specialist)
Salary: $49 025 - 77 955 per year
Published at: Nov 21 2024
Employment Type: Full-time
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. The C&P Specialist is aligned to and supervised by the C&P Manager.
Duties
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.
Preferred Experience: Nursing Credentialing and VETPRO experience preferred. Experienced with primary source verifications to include Education, Training, Licensure, and Board Certification.
Work Schedule: Monday - Friday, 8:00 am - 4:30 pm (subject to change based on agency needs)
Virtual: This is not a virtual position.
Position Description/PD#: Health System Specialist (Credentialing & Privileging Specialist)/PD99620-S and PD99876-S
Permanent Change of Station (PCS): Not authorized
PCS Appraised Value Offer (AVO): Not authorized
Qualifications
To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 11/26/2024.
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-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.
See the Required Documents Section for additional information on acceptable SF-50(s)
You may qualify based on your experience and/or education as described below:
GS-07 Grade Level:
Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-05 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to 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.
OR,
Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have completed 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). Education at the graduate level must have been obtained in an accredited college or university and must demonstrate the knowledge, skills, and abilities necessary to do the work of this position.
OR,
Superior Academic Achievement (SAA): Completion of all the requirements for a bachelor's degree in a curriculum that is qualifying (i.e. hospital administration, public health administration, or related fields such as course work in health care administration) for the position to be filled and I 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; and Membership in a national honor society (other than freshman honor societies) recognized by the Association of College Honor Societies.
OR,
Combination: Applicants may also combine education and experience to qualify at this level. You must have a combination of specialized experience and education beyond the graduate level.
GS-09 Grade Level:
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 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.
OR,
Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have completed a master's or equivalent graduate degree or successfully completed two (2) full years of progressively higher level graduate education leading to such a degree. 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). The education portion must include courses that demonstrate the knowledge, skills, and abilities necessary to do the work of this position. Education must have been obtained in an accredited college, or university.
OR,
Combination: Applicants may also combine education and experience to qualify at this level. You must have a combination of specialized experience and education beyond the first year (18 semester hours) of graduate education to meet total qualification requirements.
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.
Physical Requirements: Work is mostly sedentary, occasionally light physical effort may be required.
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
Basic - Individual Occupational Requirement:
A. Education: I possess a bachelor's or graduate level degree in a major field of study such as hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. OR
B. Specialize Experience For positions above GS-05: I possess 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. OR
C. 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:1)Assignments providing a knowledge of basic health system administration philosophies, practices, and procedures, and basic government administrative policies and requirements;2)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 3) Oversight by an experienced health system administrator with periodic evaluation of the individual's progress and appropriate adjustment of the training program.
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.
Contacts
- Address Columbia VA Health Care System
6439 Garners Ferry Road
Columbia, SC 29209
US
- Name: Edmund Crawford
- Email: [email protected]
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