Health System Specialist (Credentialing & Privileging)

Full Job Description

The incumbent serves as a Supervisory Health Systems Specialist (organizational title is Credentialing and Privileging Manager) and is assigned to the Medical Staff Office, which is under the Chief of Staff (COS) at Hines VA Hospital.

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

BASIC REQUIREMENTS: You must have one of the following: EDUCATION: Undergraduate or Graduate 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, EXPERIENCE: 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 Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement IN ADDITION TO MEETING THE BASIC REQUIREMENTS LISTED ABOVE, YOU MUST MEET THE FOLLOWING GRADE REQUIREMENTS TO QUALIFY FOR THIS POSITION.

GS-12 Grade Requirements: 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: Extensive knowledge of medical specialties, medical terminology and design of implementation of best practices for criteria based privileging systems for granting of clinical privileges and/or reduction and/or revocation of clinical privileges Expert knowledge of the healthcare industry and/or experience with Medicare and third-party payer coding and billing practices.

Extensive knowledge and skill in interpreting C&P as well as staffing regulations/requirements for healthcare practitioners in compliance with a broad range of National and Local handbooks, directives, MOUs, policies, bylaws and a variety of auditing and accrediting agencies Ability to conduct meetings with various services both clinical and administrative on a regular basis to ensure they are knowledgeable about identified VHA performance measures and monitors that fall under their scope and are aware of their impact on accreditation and the medical centers performance Preferred Experience: Leadership and/or supervisory experience in a healthcare setting 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.

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/.

Major Duties:

The Supervisory Health System Specialist 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.

As the VAMC's C&P Program subject matter expert (SME), the incumbent provides direct technical and administrative supervision to employees in the VAMC's C&P Office.

The incumbent is responsible for ensuring that employees are efficiently and effectively accomplishing quality work that is compliant with regulatory requirements and procedures, TJC standards, laws, and VHA C&P policies and requirements, as well as assuring implementation and accomplishment of the goals and objectives of the C&P Program.

As the supervisor, the incumbent: 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 Develops, modifies, and/or interprets performance standards; outlines and explains performance expectations to staff; assigns and reviews work performed by subordinates based on priorities, consideration of complexity and requirements of assignments and employee skill level; evaluates work performance mid-year and annually, and provides regular feedback on employees' strengths and weaknesses Provides advice, counsel, and instruction to employees on work and administrative matters; serves as approving official for leave requests and approving official for credit card purchases and reconciliations; conducts staff meetings and composes minutes.

Identifies developmental and training needs of employees; provides or arranges for needed development and training; advocates to leadership and/or program officials for training resources Senior Program Advisor - provides consulting and guidance to local leadership and C&P employees on all matters pertaining to the facility's C&P program including Healthcare Professionals C&P, National and VISN Memorandums of understanding; VA Memos; VHA requirements; Handbooks, Directives and Policies Primary consultant for the facility's C&P program; analyzes program audit results; interprets facility quarterly report card data; identifies potential privileging issues; drafts facility medical staff bylaws updates and revisions.

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 practice for accuracy, setting specific indicator and signature appropriations as required for VAMC compliance with Joint Commission Standards Work Schedule: Monday - Friday 7:30am - 4:00pm Position Description Title/PD#: Health System Specialist (Credentialing & Privileging)/PD99874A 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.