Lead Health System Specialist - Credentialing & Privileging

Full Job Description

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 at the GS-11 level, you must meet one of the following: Specialized Experience: You must have at least one (1) full year of specialized experience equivalent to at least the next lower grade level (GS-9) in the Federal Service, that is directly related to the work of the position and has equipped you with the particular knowledge, skills and abilities to successfully perform the duties as a Health System Specialist.

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.

At this level, applicants would have obtained this experience working within a health care setting, working directly with clinicians and other administrators to solve problems in support of the delivery of patient care; and ensuring compliance with policy and directives related to a health care credentialing and privileging program.

~OR~ Education: Successfully completed a Ph.D., equivalent doctoral degree, 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: Combinations of successfully completed graduate level education (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.

Physical Requirements and Work Environment: 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.

The work is performed in an office setting which requires normal safety precautions typical for offices and meeting rooms. The work area is adequately lighted, heated, and ventilated. 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) to providers and service chiefs regarding routine and complex matters related to C&P including provider competence for the ongoing provider practice evaluation (OPPE) and focused provider practice evaluation (FPPE).

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: Telework: Not Available Virtual: This is not a virtual position.

Position Description/PD#: Lead Health System Specialist - Credentialing & Privileging/PD99418S Relocation/Recruitment Incentives: Not Authorized