Health System Specialist (Credentialing & Privileging Analyst)

Summary Responsible for conducting analytical reviews, managing and tracking data, and serving as an advisor on key processes related to the Credentialing and Privileging (C&P) program. Applies analytical and evaluative methods and techniques for assessing the effectiveness, efficiency, and compliance of key program processes and makes recommendations to leadership for improving policies, processes and procedures. Responsibilities Major duties and responsibilities include but are not limited to the following: Responsible for the implementation, maintenance, and update of Focused Professional Practice Evaluations (FPPE) and Ongoing Professional Practice Evaluations (OPPE) monitoring systems in support of all divisions of the VAMC; for providers in full-time, part-time, temporary, intermittent, contract, without compensation (WOC) and fee basis appointments in accordance with VHA C&P directives, handbooks and policies; Joint Commission (TJC) Standards; and State and Federal Regulations. Analyzes clinical evaluation plans to assure that they meet standards and are thorough and appropriate to measure and document the clinical competence of the Licensed Independent Practitioner (LIP). Assembles complete packages for Medical Staff Committee Process. Gathers, analyzes, documents and tracks program data from beginning to end ensuring program compliance. Conducts analytical assessments for program processes and procedures; and manages data collection and reporting outcomes. Participates in the development of OPPE, FPPE and privilege forms. Generates and analyzes facility Report Cards. Identifies issues and recommends corrective actions to supervisor, VAMC leaders, or administrative support personnel as appropriate and estimates compliance timelines for resolution. Evaluates Joint Commission standards, Federal and State Regulations, and new VA directives, memos, policies, notices and procedures and determines their impact on the FPPE and OPPE and other key components of the C&P program. Ensures initiation, completion and compliance of FPPE and OPPE clinical evaluations to include providing guidance and assistance in accordance with all requirements and standards and monitoring the evaluations status. Conducts audits on provider time-limited credentials, provider C&P two part folders, the provider exit review monitoring system, privileging documents, the FPPE and OPPE tracking systems, credentialing program training requirements, telehealth providers monitoring system, and any Committee recommended actions. Manages special projects for new program initiatives and requirements and for process improvements and changes; provides data analysis support; leads in implementation practices and procedures. Work Schedule: Monday- Friday, 08:00 am- 04:30 pm. 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 may be authorized for telework. Telework eligibility will be discussed during the interview process. Virtual: This is not a virtual position. Position Description/PD#: Health System Specialist (Credentialing & Privileging Analyst)/PD99877S Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Requirements Conditions of Employment You must be a U.S. Citizen to apply for this job Selective Service Registration is required for males born after 12/31/1959 You may be required to serve a probationary period Subject to background/security investigation Selected applicants will be required to complete an online onboarding process Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) – See “Additional Information” below for details. Qualifications To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 10/20/2024. 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. 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. Individual Occupational Requirement: To meet the basic qualification of the 0671 Health System Administration Occupational Series: Possess an undergraduate or graduate level degree with a major study in hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration; OR, 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: 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; OR, Completed an agency-sponsored on-the-job training program that was a formal individualized training plan within a 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 individuals progress and appropriate adjustment of the training program. Proof of successful completion of an agency-sponsored on-the-job training program is required. In addition to meeting the Individual Occupational Requirement (IOR), you may qualify based on your experience and/or education as described below: GS-09 Experience and/or Education: 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:performing duties associated with healthcare credentialing and privileging. Qualifying specialized experience is defined as 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 a masters 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. NOTE: Transcripts must be submitted with your application materials. Education cannot be credited without documentation. OR, Combination of Experience/ Education: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond one (1) year of graduate education. To calculate, first identify the percentage of required education you have earned (when substituting, you cannot use the first year of graduate education). Then identify the percentage of required experience you possess. Add the two percentages. The total percentage must equal at least 100 percent to qualify. . You will be rated on the following Competencies for this position: Analysis and Problem Solving Critical Thinking Customer Service Information 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 mostly sedentary. Occasionally, light physical effort may be required, such as that involved with walking, stair climbing, and carrying of light office items. For more information on these qualification standards, please visit the United States Office of Personnel Managements 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. If you are basing your qualifications on education (or a combination of education and experience) or if the position requires a college education to qualify, you must submit a copy of your transcripts with your application. Your official or unofficial transcript must reflect: name of the college or university, full address of the college or university, your name, class title(s) with the number of credits earned/completed, the degree received, if applicable, and date degree conferred. A copy of your certificate/degree or screenshot of your current classes are not a replacement of your transcript and they will not be used in the qualifying process. 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/. Additional Information The Career Transition Assistance Plan (CTAP) provide eligible displaced Federal/VA competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation (a copy of the agency notice, your most recent performance rating, and your most recent SF-50 noting current position, grade level, and duty location) and be found well-qualified for this vacancy. To be well-qualified: applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the required competencies of the job. Information about ICTAP and CTAP eligibility is on OPMs Career Transition Resources website at http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/. This job opportunity announcement may be used to fill additional vacancies. Pursuant to VHA Directive 1193.01, VHA health care personnel (HCP) are required to be fully vaccinated against COVID-19 subject to such accommodations as required by law (i.e., medical, religious or pregnancy). VHA HCPs do not include remote workers who only infrequently enter VHA locations. If selected, you will be required to be fully vaccinated against COVID-19 and submit documentation of proof of vaccination before your start date. The agency will provide additional information regarding what information or documentation will be needed and how you can request a legally required accommodation from this requirement using the reasonable accommodation process. If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement. VA Healthcare System Serving Ohio, Indiana and Michigan (VISN 10) advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care, you will operate in a model with three core elements, seeking to create a personalized health plan for each Veteran. This is done in the context of healing relationships and healing environments and a connection back to the Veterans community. This aligns with the Veterans Health Administration (VHA) Mission Statement to Honor Americas Veterans by providing exceptional health care that improves their health and well-being. Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicants criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.