The primary functions of the incumbent are to assist the Primary Care/Managed Care Product Line (PC/MC PL), in providing advisory and technical assistance to beneficiary patients seeking medical care, information or guidance from the contracted Community Based Outpatient Clinics (CBOC). The incumbent is assigned as a Program Assistant in the Primary Care Managed Care Product Line of the South Texas Veterans Health Care System (STVHCS).

Duties

Major Duties: Data Analysis: The PA is responsible for the accountability of over 23 million dollars for CBOC contract services. The incumbent obtains information from the various contracts as they relate to payment rates and prepares monthly enrollment listing for payment of services performed at each CBOC. She/He reviews and analyzes bills received for payment to: (1) ensure charges are within negotiated contract; (2) eliminate any unnecessary or duplicate charges; (3) verify the patient was seen at the facility in question; (4) validate bills against actual patient information. Incumbent is the point-of-contact for billing inquiries for the various CBOC contracts. Handles patients concerns and issues and working with the Program Specialist to ensure all the needs of the Veterans are met timely. Handles suspenses assigned timely and ensure all the needs of the contract needs are met. Incumbent is responsible for maintaining up-to-date financial fund control point obligations. This includes establishment of 1358's, 2237's, and decreasing and increasing obligations as necessary. She/He utilizes the Veteran's Health Administration (VHA) Financial Management System (FMS), Control Point Activity, Accounting and Procurement (IFCAP) to monitor both the obligated and unobligated balances. The PA assists the CBOC Program Specialist in projecting the need for additional funding requirements to senior management. Administrative Duties: The incumbent works closely with the CBOC Program Specialist. He/She assists CBOC Program specialist in orienting and advising the CBOC personnel regarding the VA regulations, policies and procedures on administrative matters, basic eligibility for benefits and status for evaluation into CBOC. Through constant surveillance, maintains contact with medical and administrative staff in various areas/services to resolve delays and misunderstandings in the medical administrative aspects of providing medical care. Work Schedule: Monday-Friday / 0730-1600 Virtual: This is not a virtual position. Position Description/PD#: Program Assistant/PD00827O Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 12/30/2024. 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-06 position you must have served 52 weeks at the GS-05. 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. You may qualify based on your experience as described below: 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: obtains information from the various contracts as they relate to payment rates and prepares monthly enrollment listing for payment of services performed; reviews and analyzes bills received for payment to: (1) ensure charges are within negotiated contract; (2) eliminate any unnecessary or duplicate charges; (3) verify the patient was seen at the facility in question; (4) validate bills against actual patient information. Knowledge of billing inquiries for various contracts. Knowledge on maintaining up-to-date financial fund control point obligations. You will be rated on the following Competencies for this position: - Customer Service - Contracting/Procurement - Administration and Management 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: The work is sedentary. Some work may require movement between offices, hospitals, warehouses, and similar areas for meetings and to conduct work. Work may also require walking/standing, in conjunctions with travel to and attendance at meetings and/or conferences away from the work site. Incumbent may carry and lift light items weighing less than 15 pounds. 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

There is no educational substitution at this grade level.

Contacts

• Address Audie L Murphy Memorial Veterans Hospital 7400 Merton Minter Boulevard San Antonio, TX 78229 US
• Name: VISN 17 SSU USAS Group
• Email: [email protected]