Program Specialist (Customer Service)

Full Job Description

The Program Specialist (Customer Service) serves as a Customer Service Liaison and Service Level Advocate for the all Community Care programs and functions.

The primary purpose of this position is to improve the Veteran and community care provider experience.

Performs reviews by examining Veterans' medical records, community care authorizations and referrals, community payment records and historical tracking of submitted health care claims.

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 this GS-7 position you must have served 52 weeks at the GS-5. For this GS-9 position you must have served 52 weeks at the GS-7.

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 VA employees applying for reinstatement with CTAP eligibility.

Specialized Experience (GS-7): You must have one year of specialized experience equivalent to at least the next lower grade (GS-5) in the normal line of progression for the occupation in the organization.

Specialized Experience include (but are not limited to): Assist in the development of detailed training materials and teaching aids to conduct formal and informal training sessions to vendors, Veterans, Congressional Offices, large hospital associations, medical center staff and other stakeholders, administer duties, priorities, commitments, polices, precedents, procedures, practices, goals, objectives, laws, VA guidelines and program goals of both administrative and clinical services of Community Care in order to respond to concerns expressed by patients and their families, foster the abilities to solve complex problems associated with the day to day operations concerning customer service issues in a positive, goal-oriented way, and ability to take quick and effective action when necessary.

OR Education: Applicants may substitute education for the required experience.

To qualify based on education for this grade level you must have 1 full year of graduate level education or superior academic achievement (Transcripts required).

Specialized Experience (GS-9): You must have one year of specialized experience equivalent to at least the next lower grade (GS-7) in the normal line of progression for the occupation in the organization.

Specialized Experience include (but are not limited to): Administers Federal laws, VA regulations and directives governing medical benefits for veterans; facility policies, procedures and organizational structure; medical terminology; services available, capabilities of clinics; and must be aware of changes which affect veterans' benefits, implements health services research methods, including data collection and management methods, analysis design, interpretation of study results and translation of study results into action plans., performs high degree of skill and written communication as well as interpersonal relations, effectively review and interpret information contained in medical and administrative records, and utilizes analytical abilities is required in reviewing policies, identifying existing issues and potential issues and suggesting solutions or alternative to existing procedures which may contribute to those issues.

OR Education: Applicants may substitute education for the required experience.

To qualify based on education for this grade level you must have 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) (Transcripts required).

You will be rated on the following Competencies for this position: Manages and Organizes Information Decision making Information Management Problem Solving Customer Service 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 primarily sedentary, although some walking, standing, bending, or carrying of light items may be required.

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 not limited to: Receives and hears complaints, grievances and other requests for information from Veterans or from individuals acting on behalf of the Veteran.

Monitors and evaluates corrective measures taken.

Investigates complaints, initiates action/appeals or change to rectify the situation and reports corrective measures taken to parties involved Communicates with the patient and his/her family and with clinical and administrative staff, Veteran's Affairs (VA), and private sector, to enhance responsiveness in meeting the health care needs of Veterans.

Communicates with the patient and his/her family and with clinical and administrative staff, Veteran's Affairs (VA), and private sector, to enhance responsiveness in meeting the health care needs of Veterans.

Serves as the liaison for the patient/family, vendor, Veterans Board of Appeals, Congressional Liaisons, District Counsel, Veteran's Integrated Service Network (VISN) 16, the GVSMVAM, and Community Care Office and provides a channel through which the unit can respond to patients' needs and concerns.

Makes appropriate referrals to other services and provides follow-up to ensure that satisfactory service has been provided.

Acts on behalf of the Community Care Service Chief to resolve escalated issues, expedite services, to operations and meet the needs of the organization.

Provides accurate and well-developed responses to various heightened inquires within the established timeframe.

Provides management with customer feedback to be used to identify the dimensions of care that have the potential to make a difference in overall satisfaction, retention or other desired outcomes.

Gathers, analyzes, and prepares information while applying sound judgement when responding to inquiries.

Collaborates with Veterans and vendors regarding procedural, technical and/or operational functions within the Office of Community Care.

Contributes to service recovery while completing complex requests in a timely and efficient manner.

Organizes, completes, summarizes and analyzes the data collected and develops reports which reflect the scope of activities and identifies trends and opportunities for improvement.

Obtains and researches necessary documentation needed to resolve multifaceted issues, while establishing outreach and flow of communication to meet customers' needs.

Maintains records of all inquires utilizing tracking programs and documents.

Takes inquiries from Veterans, their family members, and/or representatives and uses research tools, assessment of data, and research modalities in order to get the data to support the response.

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, 8:00am - 4:30pm, subject to change based on the needs of the facility Virtual: This is not a virtual position.

Position Description/PD#: Program Specialist (Customer Service)/PD84251A and PD84252A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized