Health System Specialist

Full Job Description

About the Position: Serves as advisor and coordinator in the hospital's credentialing program within area of responsibility to provide support to health care management officials by researching, evaluating, advising on and coordinating healthcare provider (HCP) credentials and credentialing system operations.

This is a Direct Hire Solicitation Who May Apply: US Citizens In order to qualify, you must meet the experience and/or education requirements described below.

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; religious; spiritual; community; student; social).

You will receive credit for all qualifying experience, including volunteer experience.

Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application.

Additional information about transcripts is in this document.

GS-07 Specialized Experience: One year of specialized experience which includes reviewing healthcare delivery systems and processes for trends or deviations in patient care; utilizing healthcare systems and office automation software to enter and retrieve data; assisting with the credentialing process for providers and staff within a medical treatment facility (MTF).

This definition of specialized experience is typical of work performed at the second lower grade/level position in the federal service (GS-05).

OR Education: One full year of graduate level education 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 Superior Academic Achievement: Successful completion of all the requirements for a bachelor's degree with Superior Academic Achievement.

In order to be creditable under this provision, Superior Academic Achievement must have been gained in a curriculum that is qualifying for the position to be filled, such as that identified in Education above.

Superior Academic Achievement is based on: (1) Class Standing - Applicants must be in the upper third of the graduating class in the college, university, or major subdivision, such as the College of Liberal Arts or the School of Business Administration, based on completed courses; OR (2) Grade-Point Average (G.P.A.) - Applicants must have a grade-point average of either (a) 3.0 or higher out of a possible 4.0 ("B" or better) as recorded on your official transcript, or as computed based on 4 years of education, or as computed based on courses completed during the final 2 years of the curriculum; or (b) 3.5 or higher out of a possible 4.0 ("B+" or better) based on the average of the required courses completed in the major field or the required courses in the major field completed during the final 2 years of the curriculum.; OR (3) Honor Society Membership - Applicants may be considered eligible based on membership in one of the approved national scholastic honor societies listed by the Association of College Honor Societies (https://www.achshonor.org/).

OR Combination of Education and Experience: A combination of education and experience may be used to qualify for this position as long as the computed percentage of the requirements is at least 100%.

To compute the percentage of the requirements, divide your total months of experience by 12. Then divide the total number of completed graduate semester hours (or equivalent) by 18.

Add the two percentages.

GS-09: Specialized Experience: One year of specialized experience which includes assisting with managing daily administrative operations for a healthcare facility or clinic; analyzing healthcare processes to improve healthcare delivery systems; and/or performing quality and/or risk management assessments.

This definition of specialized experience is typical of work performed at the second lower grade/level position in the federal service (GS-07).

OR Education: Master's or equivalent graduate degree or 2 full years of progressively higher-level graduate education leading to such a 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 Combination of Education and Experience: A combination of education and experience may be used to qualify for this position as long as the computed percentage of the requirements is at least 100%.

To compute the percentage of the requirements, divide your total months of experience by 12.

Then divide the total number of completed graduate semester hours (or equivalent) beyond the first year (total graduate semester hours minus 18) by 18. Add the two percentages. Major Duties:

• Provide consultation services to assigned department, service line, or facility on interpretation and development of the requirements the Credentialing/Privileging program.
• Serve as subject matter expert for assigned area regarding regulations and local policy standards for privileging and subsequent renewal or reappointment.
• Interpret and analyze regulations, directives, and policies relevant to the privileging and reappointment process and advises on proposed new directives.
• Initiate and maintain credentials files for each health care provider (HCP).
• Perform detailed reviews of information for chronology of education, training, employment and reasons for periods of unemployment or relocations for the purpose of spotting inconsistencies or attempts to conceal information.
• Obtain and interpret data from licensing agencies and National Practitioners Data Bank.
• Assemble credentialing/privileging information and data and submit packet for review and approval by the credentials committee.
• Conduct regular screening of files maintained on individual health care providers.
• Follow prescribed directives and policies to ensure credentialing records are up-to-date and comply with regulatory requirements.
• Give orientations to management officials on procedures and regulatory controls associated with the credentialing program.
• Develop and present written and oral reports associated with activities within the credentialing program.