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Supervisory Health Systems Specialist (Credentialing& Privileging)

Company: Department of Veterans Affairs
Location: Poplar Bluff
Posted on: June 12, 2021

Job Description:

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Summary

The John J Pershing VA Medical Center is currently seeking a Supervisory Health Systems Specialist (Credentialing and Privileging) for Poplar Bluff, MO.

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Responsibilities

The Supervisory Health Systems Specialist is assigned to the Medical Staff Office, which is under the Chief of Staff at a VA Medical Center (VAMC). The incumbent oversees all functions related to healthcare providers' professional credentials supporting all divisions of the VAMC (i.e. full time, part time, temporary, intermittent, contract, without compensation (WOC) and fee basis) in accordance with VHA Credentialing and Privileging (C&P), Directives, VA Handbooks, Policies, Memos, and Notices; The Joint Commission (TJC) Standards and State and Federal Regulations.

Duties include but are not limited to:

  • Identifies and presents to leadership the resources necessary for accomplishing the mission and function of the facility's C&P program.
  • Manages the C&P staff; sets and adjusts short and long-term priorities; assesses staffing needs; plans work to be accomplished; and ensures positions are appropriately manned to cover all program functions.
  • Provides consulting and guidance to local leadership and C&P employees on all matters pertaining to the facility's C&P program.
  • Determines appropriate actions, including those resulting from VISN and local level reviews, initial and recredentialing processes, including, but not limited to primary source verifications; reporting and data trends, identified issues that require further review, and electronic credentialing database and clinical privilege maintenance.
  • Attends committee meetings and presents providers' credentials, clinical practice histories and red flags; documents and composes committee minutes, privileging requests and/or actions, malpractice payments, tort claims and adverse actions, Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE) reviews and completion timeframes.
  • Serves as the primary consultant for the facility's C&P program.
  • Coordinates with Service Chiefs and service level administrative teams for annual Committee(s) review of clinical privileges and scope of practice forms; reviews clinical privileges and scope of practices for accuracy, setting specific indicator and signature appropriations as required for VAMC compliance with Joint Commission Standards.
  • Participates in policy and decision-making initiatives at the VAMC, and continuously develops a greater understanding of regulatory and policy requirements, quality assurance methodologies as well as best practices.
  • Implements tracking and monitoring systems for actions indicated by the Credentials Committee, such as licensed provider's exit review forms, Service Chief and supervisory requirements, state licensing board reporting requirements, and state licensing board reporting correspondences.
  • Validates processes that are working efficiently and according to plan to identify dysfunctional process issues as early as possible during the implementation phase. Where processes, reports, metrics, or other stated requirements laid out in the initiative are found to be dysfunctional, the incumbent makes recommendations for corrective action for adoption.
  • Provides consultation and oversight in the following areas: FPPE and OPPE; actions indicated by the Credentials Committee; application process analyzing exceptions and deviations; telehealth program; professional education and training; peer recommendations; licensure, board certification, malpractice claims, possible omissions and inconsistencies; data entry accuracy; VA policies and regulations; and accreditation and health care industry standards.
  • Serves as the administrator for the TRJC. This involves managing enrollments, single queries and re-enrollments; preparing and submitting reports for adverse privileging actions; submitting federal tort claims for substandard clinical care per the Office of General Counsel; ensuring that primary source verification is obtained and processed via quality control review. Coordinates with Service Chiefs, VISN Chief Medical Officer, and Committee for Reviews and Recommendations when query results require action.

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: 8:00am -4:30 pnm Monday- Friday

Telework: Ad-Hoc as needed

Virtual: This is not a virtual position.

Position Description/PD#: Supervisory Health Systems Specialist (Credentialing& Privileging)/PD99874A

Relocation/Recruitment Incentives: Not Authorized

Financial Disclosure Report: Not required

Travel Required

Not required

Supervisory status

Yes

Promotion Potential

12

  • Job family (Series)

0671 Health System Specialist

  • Requirements

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Requirements

Conditions of Employment

  • You must be a U.S. Citizen to apply for this job
  • Designated and/or random drug testing may be required
  • 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

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 06/21/2021.

Individual Occupational Requirement (IOR): The Health System Specialist Series has an IOR. In order to meet the basic requirement of the Health System Administration, 0671 Occupational series, you must:

  • 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
  • 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: 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 and oversight by an experienced health system administrator with periodic evaluation of the individual's progress and appropriate adjustment of the training program.

Time in Grade: 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-11 position you must have served 52 weeks at the GS-9. For a GS-12 position you must have served 52 weeks at the GS-11. 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 and/or education as described below:

Specialized Experience GS-11

  • Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-09 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Leadership or program oversight experience in an office setting where attention to detail is critical; Experience with credentialing dependent and independent medical providers: experience with coordinating credentialing and privileging for appointments, reappointment and/or change in status; knowledge with Professional Standards boards actions and processes; experience with software programs; conducting audits and reviews of program elements; assure documents are accurate, complete, current and in compliance with VHA and other governing body directives; serve as the principal advisor providing consultation and guidance to local leadership on all matters related to program elements such as credentialing or other programs. OR,
  • Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have have a Ph.D. or equivalent doctoral degree or three full academic years of progressively higher-level graduate education leading to a doctoral degree in a field closely related to the duties of the position. 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 some specialized experience equivalent to the GS-9 grade level but less than one year, and I have more than two years, but less than three years of graduate education. I have computed the percentage of these requirements that I meet, and the total is at least 100% for the GS-11 grade level.

Specialized Experience GS-12

  • Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-11 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: provide consultation and guidance to local leadership on all matters pertaining to the C&P Program to include adverse privileging actions; research provider credentialing requirements and interpret/explain new regulatory requirements related to the C&P Program; performs quality assurance checks and ensure compliance; manage the C&P staff and ensures employees are accomplishing quality work that is compliant with regulatory requirements and procedures.

You will be rated on the following Competencies for this position:

  • Analytical Thinking
  • Critical Thinking
  • Organizational Stewardship
  • Planning and Evaluating
  • Standards

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 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: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.

Keywords: Department of Veterans Affairs, Memphis , Supervisory Health Systems Specialist (Credentialing& Privileging), Other , Poplar Bluff, Tennessee

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