Medical Management Specialist

Full Job Description

Vacancy Identification Number (VIN): 12899922. Please read this announcement in its entirety before beginning the application process to ensure you submit all the required documents.

See Required Document sections in this announcement before applying. Please read the application questionnaire before applying: https://apply.usastaffing.gov/ViewQuestionnaire/12899922.

Federal Resume Tips, Please READ To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 03/09/2026.

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-09 position you must have served 52 weeks at the GS-07.

For a GS-11 position you must have served 52 weeks at the GS-09.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.

In addition to the time in grade requirements listed above, the below qualification requirements must be met at the grade in which you are applying.

You may qualify based on your experience as described below: GS-09 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-07 in the normal line of progression for the occupation in the organization.

Examples of specialized experience would typically include, but are not limited to: Knowledge and experience in the field of health care administration and delivery systems for the provision and execution of outpatient care; Knowledge of VA regulations and laws governing VA medical benefits and of care and the overall programs related to the health care delivery system; the Privacy Act; Joint Commission Standards, Health Insurance Portability and Accountability Act (HIPAA), state and federal laws; Knowledge of the substantive programs and organizational structure of the VAMC to gather information, analyze data and develop and write detailed reports; Knowledge of basic principles and practices of the Business Office in conducting budget and financial management, file, database and records management, coordination of activities and communication that supports service operations, coordination and tracking of human resources actions, procurement and contracting, statistical and other administrative functions; Experience in applying analytical and evaluative methods and techniques to issues or studies concerning the efficiency and effectiveness of program operations; Knowledge and experience in the field of outpatient administration, benefits and eligibility, medical records, and related fields of medical administration; Ability to deal with a variety of individuals with tact and diplomacy.

OR, Education: Applicants may substitute education for the experience required for the GS-09 level.

Master's or equivalent graduate degree, or 2 full years of progressively higher level graduate education leading to such a degree, or LL.B, or J.D., if related.

Education must have been obtained in an accredited college or university and must demonstrate the knowledge, skills, and abilities necessary to do the work of this position.

NOTE: Transcripts must be submitted.

Education cannot be credited without documentation (TRANSCRIPTS REQUIRED) OR Combination: Applicants may also combine education and experience to qualify at this level.

You must have an combination of specialized experience and education beyond one year of graduate education. (TRANSCRIPTS REQUIRED).

GS-11 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-09 in the normal line of progression for the occupation in the organization.

Examples of specialized experience would typically include, but are not limited to: Broad knowledge and experience in the field of health care administration and delivery systems for the provision and execution of outpatient care.

Extensive knowledge of VA regulations and laws governing VA medical benefits and of care and the overall programs related to the health care delivery system; the Privacy Act; Joint Commission Standards, Health Insurance Portability and Accountability Act (HIPAA), state and federal laws.

In-depth knowledge of the substantive programs and organizational structure of the VAMC to gather information, analyze data and develop and write detailed reports.

Knowledge of medical eligibility and public law pertaining to health care for Veterans, billing for medical services provided, state and local laws for billing activity.

Knowledge, sufficient to manage and lead staff who routinely support registrations, scheduling, coding, revenue, transportation, and scanning including but not limited to VISTA, VS GUI (VSE), Insurance Capture Buffer (ICB), Patient Check-In (PCI), Enrollment System (ES), Veteran Benefits Management System (VBMS), and ROI-Plus.

Knowledge and skill in applying analytical and evaluative methods and techniques to issues or studies concerning the efficiency and effectiveness of program operations.

Broad knowledge and experience in the field of outpatient administration, benefits and eligibility, medical records, and related fields of medical administration.

Develop and apply financial management techniques and methodologies to plan, execute, and review programs within the Business Office.

Ability to deal with a variety of individuals with tact and diplomacy. OR, Education: Applicants may substitute education for the required experience.

To qualify based on education for this grade level you must have Ph.D.

or equivalent doctoral degree or 3 full years of progressively higher-level graduate education leading to such a degree or LL.M., if related. (TRANSCRIPTS REQUIRED).

OR, Combination: Applicants may also combine education and experience to qualify at this level.

You must possess equivalent combinations of successfully completed graduate level education (in excess of the first two years or 36 semester hours) and specialized experience to meet total experience requirements.

NOTE: Transcripts must be submitted. Education cannot be credited without documentation (TRANSCRIPTS REQUIRED).

You will be rated on the following Competencies for this position: Administration and Management Financial Management Organizational Performance Analysis Planning and Evaluating Quality Assurance 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.

Major Duties:

This job opportunity announcement (JOA) will be used to fill one

full-time, permanent Medical Management Specialist, GS-0301-11, vacancy with the Business Office Service at the Louisville, KY VA Medical Center.

The incumbent is responsible for the administration of all patient support activities including registration, enrollment, eligibility, emergency transportation (ambulance), after-hours administrative and emergency operations, data integrity and validation, outreach, decedent affairs, beneficiary travel, administrative and technical support in direct patient care areas, telephone and information reception operations, bed management, and Health Information Management (HIMS) including Release of Information, Medical Coding, Clinical Documentation Improvement, Scanning, and Medical Records throughout the entire facility and eight CBOCs.

The incumbent performs key duties in the areas of program management analysis, administration, and coordination of these programs/activities as well as to the lower supervisory and lead positions.

Responsibilities primarily encompass strategic planning and directing, as well as management and coordination of all Business Office activities involving front-line interaction with Veterans and the public in accordance with all established federal, legal, regulatory, and policy directives at the VAMC.

S/he will analyze trends and processes, coordinate with process improvement specialist(s) and/or teams to improve processes, and ultimately improve patient care programs in the organization.

The incumbent provides a high level of administrative support to Business Office, senior leadership, and clinical services.

The primary function of this position is to provide leadership guidance and direction in Beneficiary Travel, Decedent Affairs, Emergency and Special Mode Transportation, Medical Administrative Assistants (MAA), Enrollment, Eligibility, Data Integrity and Validation, HIMS, Clinic Profile Management, and telephone operations and to provide support to the section's supervisors.

Major duties include but are not limited to: Assures staff capabilities through recruiting, continuing short and long-term training, and staff participation in meetings and seminars.

Incumbent administers space and equipment programs. Serves as the approving official for orders, supplies, services, and equipment.

Performs evaluation and analysis of areas targeted for improvement to assess program effectiveness and current status and to identify areas requiring management attention and systems enhancement.

Identifies existing or potential problem areas and recommends necessary corrective action, or redesign.

Completes necessary documentation to monitor and track project accomplishments and resource utilization.

Ensures that project deliverables meet defined functional and technical specifications; and conducts post-project evaluations.

Ensures that projects are based on sound lean management and High Reliability Organization (HRO) principles and that improvements are sustained over time.

Develops, utilizing lean, HRO and QMS principles, analyzes and evaluates systems by review of reports, available data, studies, projects, and information provided by Business Office staff.

Maintains linkages and effective communications with the PCI Team on a regional level to ensure optimal PCI educational opportunities for facility staff.

Provides oversight for the establishment of guiding processes, principles, and policies for the development and implementation of Veteran-centric PCI programs at the facility level, and for the operation and management of PCI programs.

Provides oversight and direction by conducting analysis of workload trends, projections for all administrative and outpatient activities. Compares and contrasts current and historical workload data.

Reviews, verifies, and analyzes data submitted for consistency with financial and program objectives, and adherence to VA directives.

Provides management analysis, training, and organizational development as it relates to the Business Office. Oversees monitoring of workload data transmitted nationally for VERA budgeting purposes.

Other duties as assigned.

Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met.

Selection at a lower grade level does not guarantee promotion to the full performance level. Work Schedule: Monday - Friday 8:00 a.m. - 4:30 p.m.

Telework: Adhoc Virtual: This is not a virtual position.

Position Description/PD#: Medical Management Specialist/PD403660 and PD403630 Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required