Job Information
Veterans Affairs, Veterans Health Administration Health System Specialist (Credentialing and Privileging Analyst) in Albuquerque, New Mexico
Summary The incumbent serves as a Health Systems Specialist and is assigned to the Medical Staff Office, which is under the Chief of Staff at a VA Medical Center (VAMC) and is responsible for conducting analytical reviews, managing and tracking data, and serving as an advisor to VAMC leadership on key processes related to the Credentialing and Privileging (C&P) program of the VAMC. Responsibilities Responsible for working collaboratively with medical center leadership, healthcare providers, the Credentialing and Privileging (C&P) administrative specialists, and other administrative teams in managing the Focused Professional Practice Evaluations (FPPE) and the Ongoing Professional Practice Evaluations (OPPE) for the C&P Program. Works as lead consultant for the medical center Report Card data related to the C&P Program. Gathers, analyzes, documents and tracks program data from beginning to end ensuring program compliance. Conducts analytical assessments for program processes and procedures; and manages data collection and reporting outcomes. Evaluates Our Providers database information and assesses provider State Licensing reporting information. Participates in the development of OPPE, FPPE and privilege forms. Generates and analyzes facility Report Cards. Applies technical skills to extract and analyze large datasets in a variety of formats (i.e. Access, Excel, Power Point, etc.), and manages and organizes information from various medical center repositor to present data in reports and presentations to supervisors and managers. Applies analytical skills in understanding the data, noting key issues, and making data driven decisions that impact key areas of the C&P Program. Identifies issues and recommends corrective actions to supervisor, VAMC leaders, or administrative support personnel as appropriate and estimates compliance timelines for resolution. Utilizes quantitative and qualitative skills to conduct healthcare provider industry analysis studies; assesses internal/external communication to identify substantive issues in meeting program requirements and makes adaptations or recommendations to larger internal processes/policy changes to supervisor; establishes program work priorities to meet compliance and communicates to the appropriate program manager and medical center leadership; determines baselines for complex assessments and determines which issues require tracking and further analysis. Evaluates Joint Commission standards, Federal and State Regulations, and new medical center directives, memos, policies, notices and procedures and determines their impact on the FPPE and OPPE and other key components of the C&P program and makes recommendations for local process and policy changes to the supervisor. Participates in the development and implementation of local medical center policies in accordance with Ensures initiation, completion and compliance of FPPE and OPPE clinical evaluations to include providing guidance and assistance in accordance with all requirements and standards and monitoring the evaluations' status. Implements tracking and monitoring systems for actions indicated by the Credentials Committee, such as licensed provider's exit review forms, manage requirements, state licensing board reporting requirements, and state licensing board reporting correspondences. Reviews and participates in the development of privileging forms; provides local policy updates; manages two part folder reviews and processes and ensures they are federally archived in accordance with organization system of records policy; performs credentialing and privileging system access quarterly reviews; implements monitoring system for Our Provider database; manages facility Report Card data tracking system, tracks data trends, and serves as the primary consultant to the supervisor for the development and implementation of program operations that have a direct impact on data management and process improvements. R Audits on provider time-limited credentials, provider C&P two-part folders, the provider exit review monitoring system, privileging documents, the FPPE and OPPE tracking systems, credentialing program training requirements, telehealth providers monitoring system, and any Committee recommended actions. Work Schedule: Monday to Friday, 8:00AM 4:30PM Virtual: This is not a virtual position. Position Description/PD#: Health System Specialist (Credentialing and Privileging Analyst)/PD99877S Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized Requirements Conditions of Employment You must be a U.S. Citizen to apply for this job Selective Service Registration is required for males born after 12/31/1959 You may be required to serve a probationary period Subject to background/security investigation Selected applicants will be required to complete an online onboarding process Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) - See "Additional Information" below for details. Qualifications To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 01/23/2025. 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-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 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: Individual Occupational Requirement (IOR): An IOR is a basic requirement that must be met in order to qualify for the 0671 occupational series. To qualify for this occupational series, applicants MUST have one of the following listed below: Education: Graduate education with a major field of study such as hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration (Transcript required). OR, Specialized experience: 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: Missions, organizations, programs, and requirements of health care delivery systems; Regulations and standards of various regulatory and credentialing groups; and Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement. OR, Special provision for In-service Placement: The 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 (Submit a copy of the individualized training plan with your application). 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); Oversight by an experienced health system administrator with periodic evaluation of the individual's progress and appropriate adjustment of the training program. For 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 at least the next lower grade level (GS-7) 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. Specialized experience includes: conducting analytical reviews, managing and tracking data, and serving as an advisor to medical center leadership on key processes related to the Credentialing and Privileging (C&P) program; responsible for the implementation, maintenance, and update of Focused Professional Practice Evaluations (FPPE) and Ongoing Professional Practice Evaluations (OPPE) monitoring systems in support of all divisions of the medical center. OR Education: Successfully completed 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 in a related field of the position to be filled. Education at the graduate level 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 with your application materials. OR Combination: Combinations of successfully completed graduate level education (beyond the first year) and specialized experience as described above, to meet the 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 course work in health care administration). This education must have been obtained in an accredited college or university. NOTE: Transcripts must be submitted with your application materials You will be rated on the following Competencies for this position: Analysis and Problem Solving Computer Skills Manages and Organizes Information Reasoning 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 requires some physical exertion, such as periods of standing when teaching; some walking, bending, crouching, stooping, stretching, or similar activities when visiting work sites; and some moderate lifting and carrying. At other times the work is sedentary, requiring the use of a computer. 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/. Education A transcript must be submitted with your application if you are basing all or part of your qualifications on education. 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. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/. Additional Information This job opportunity announcement may be used to fill additional vacancies. If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement. Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.