HEALTH SYSTEM SPECIALIST (CREDENTIALING AND PRIVELEGING SPECIALIST)

Full Job Description

The incumbent assists the C&P Manager/Analyst in developing short- and long-term goals necessary to accomplish the mission of the C&P program.

Assists in identifying the resources necessary for accomplishing the mission and function of the credentials and privileging program. Serves as SME in the field of credentials and clinical privileging.

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

To qualify for this position at the GS-9 level, you must meet one of the following: Specialized Experience: You must have at least one (1) full year of specialized experience, equivalent to the next lower grade level (GS-7) in Federal Service, that equipped you with the particular knowledge, skills, and abilities to successfully perform the duties of a Health System Specialist - Credentialing and Privileging, and includes 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: Successful completion of a master's or equivalent graduate degree, successfully completed two (2) full years of progressively higher level graduate education leading to such a degree, LL.B or J.D.

if related.

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).

NOTE: Copies of transcripts must be submitted with your application materials. Education cannot be credited without documentation.

OR Combination: Combinations of successfully completed graduate level education (beyond the first year) and specialized experience, as described above, to meet the total requirements.

The education portion must include graduate courses that demonstrate the knowledge, skills, and abilities necessary to do to the work of this position (i.e.

hospital administration, public health administration, or related fields such as course work in health care administration).For more information regarding SAA please visit http://www.opm.gov/qualifications/SEC-II/s2-e5.asp#e4.NOTE: Copies of transcripts must be submitted with your application materials.

Education cannot be credited without documentation.

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: 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.

Major Duties:

Duties are but not limited to: Assists C&P Manager/Analyst in drafting local credentialing processes and Medical Staff Bylaws in compliance with all applicable regulations Receives and reviews correspondence and communications for the C&P function and determines which items require immediate attention and which are confidential in nature Receives and reviews VetPro reports detecting problem areas requiring further investigation.

Researches reference materials, regulations, and standards to identify appropriate action necessary to correct the problem.

Issues of a serious nature are elevated to the supervisor for guidance Ensures accurate provider data is entered into and maintained in the VetPro computer program Ensures current information is present on providers relative to state licensure, Drug Enforcement Organization (DEA) license, National Practitioner Data Bank (NPDB) Continuous Query (CQ) enrollments and renewals, Federation of State Medical Boards (FSMB), documentation of professional education, specialty medical training, certifications, adverse licensure or privileging actions, initial and renewal of privileges which may affect the status of privileges granted for medical practice Informs C&P Manager/Analyst of trends identified, audit results and identified problems that may affect a provider's privilege status Manages provider applications (initial and renewals) for LIPs C&P within the VAMC Work Schedule: 8:00AM - 4:30PM Position Description Title/PD#: HEALTH SYSTEM SPECIALIST (CREDENTIALING AND PRIVELEGING SPECIALIST)/PD99876S Physical Requirements: The work is sedentary.

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.