Supervisory Health Insurance Specialist
Centers for Medicare & Medicaid Services
Posted: April 2, 2026 (0 days ago)
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Veterans Health Administration
Department of Veterans Affairs
Location
Salary
$74,678 - $97,087
per year
Type
Full-Time
More Healthcare & Medical jobs →Closes
Base salary range: $62,107 - $80,737
Typical requirements: 1 year specialized experience at GS-10. Ph.D. or equivalent doctoral degree, or 3 years graduate study.
Note: Actual salary includes locality pay (15-40%+ depending on location).
This job involves leading a team in the credentialing and privileging office at a VA medical center, where you'll handle administrative tasks, provide expert guidance, and ensure healthcare providers are properly verified and authorized to work.
It's a supportive role in a busy hospital environment that focuses on compliance and operations.
A good fit would be someone with experience in healthcare administration who enjoys leading others and navigating complex regulations.
The incumbent serves as a Lead Health Systems Specialist - C&P Specialist.
They are assigned to the Credentialing and Privileging (C&P) Office at a VA Medical Center (VAMC) and is responsible for providing lead administrative, consulting, technical direction and support to the C&P Specialists, C&P Manager and to program operations.
They perform a variety of C&P duties in an extremely complex VAMC or Health Care System (HCS) environment which is constantly evolving.
To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 04/06/2026.
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-11 position, you must have served 52 weeks at GS-9. 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: Health System Administration Series, 0671 Individual Occupational Requirements (IOR): Undergraduate and Graduate Education: Major Study -- hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration.
Or, Special Provision for Inservice 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 (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 individual's progress and appropriate adjustment of the training program.
In addition to meeting the IOR above, you must also meet the experience requirement described below: GS-11 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-9 in the normal line of progression for the occupation in the organization.
Examples of specialized experience would typically include, but are not limited to: health care systems missions, organizations, programs, and requirements; 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.
OR, Education: Successfully completed a Ph.D.
or equivalent doctoral degree OR three (3) full years of progressively higher level graduate education leading to such a degree, OR LL.M in the related field of the position to be filled (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 education and experience: An equivalent combination of successfully completed graduate level (beyond a master's degree) and specialized experience as described above to meet total experience 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 business or public administration with course work in health care administration).
NOTE: Transcripts must be submitted with your application materials. Education cannot be credited without documentation. Experience must be clearly indicated in your resume.
You will be rated on the following Competencies for this position: Attention to Detail Customer Service Decision Making Flexibility Integrity/Honesty Interpersonal Skills Learning Reasoning Self-Management Stress Tolerance Teamwork 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/.
Major Duties:
Duties include, but may not be limited to the following: Providing oversight and input regarding compliance with VHA policies, directives, memos, notices, The Joint Commission (TJC) standards, recommendations by the Office of Inspector General (OIG) and Government Accountability Office (GAO) and other internal or external auditors and reviewers as appropriate.
Collecting relevant data and making informed decisions to ensure qualified health care professionals are providing appropriate care in appropriate settings.
Considered a subject matter expert (SME) regarding C&P Release of Information, Nursys Verifications, VETPRO, USA Staffing, American Medical Association (AMA), American Osteopathic Association (AOA) Profiles, Federation of State Medical Boards, Malpractice Claim verifications, National Student Clearing House education verifications, Board Certifications, LIP and NON LIP file processing.
Serves as lead specialist over a group of C&P Specialists. Responsible for assigning, monitoring, and reviewing the work performed by subordinate team members.
Trains or arranges for the training of team members in methods and techniques of technical skills and team building and working in teams to accomplish tasks or projects.
Maintains reference materials, project files and relevant background documents and makes available policies, procedures, and written instructions from the C&P manager.
Serves as a first level point of contact for the offices specialists by providing high-level consultation advice and guidance and serves as a first level diffuser in difficult situations.
Participates in policy and decision-making initiatives. Ensures quality assurance in the VAMC's C&P program.
Utilizes evaluation results to make suggestions and improve organization/program performance. Conducts and oversees internal controls and audits.
Serves as a consultant and provides guidance to VAMC leadership and C&P Office Specialists on all matters pertaining to the facility's C&P program. Perform other duties as assigned.
Work Schedule:Monday-Friday, 8am-4:30pm. Work schedule may change based on agency need. Telework: Ad-hoc basis only. Virtual: This is not a virtual position.
Position Description/PD#: Lead Health System Specialist/PD99418S Relocation/Recruitment Incentives: Not authorized Critical Skills Incentive (CSI): Not approved Permanent Change of Station (PCS): Not authorized
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