Summary The Hudson Valley VAMC is looking for one (1) Advanced Medical Support Assistant. The position serves the Community Care Program in the Hudson Valley Healthcare System. The position functions as a liaison between veterans, VA providers and non-VA providers to ensure that Veterans have proper access to care within the community. Responsibilities The advanced Medical Support Position serves as a facilitator for veteran care and referrals to private sector providers and organizations within the community. As such the position acts upon referrals provided by VA Physicians to assist veterans in scheduling outside visits, ensuring veterans keep their scheduled appointments, conduct follow up necessary as part of their treatment and retrieval of medically pertinent information (medical records) and ensuring that proper billing is pre-authorized. The AMSA maintains appointment schedules for Community Care, communicates with Community Care providers pursuant to agreement or contract, prepares any required pre-appointment documents, schedules the appropriate level of care and documents the appointment in the appropriate consult and in the GUI scheduling system. Obtains medical documentation from community providers timely to close the consult by scanning into the appropriate consult within the Computerized Patient Record System (CPRS), and alerts VA providers for continuity of care. Coordinates internal and external care between customers and providers. Processes consults following Community Care guidelines, entering appropriate authorizations, if required, utilizing the correct Fund Control Point. The AMSA will ensure authorization covers the time of care requested by VA provider. The AMSA is responsible to ensure VA Medical Record information is available to the outside provider via portals, Virtu-Pro, etc. To assist in care for the veteran. The incumbent performs duties related to the receipt, intake, and indexing of health and administrative information. The AMSA will interface with person computer application as well as Vista, Community Care portals, Contracts, HSRM, JLV, PPMS, and CPRS. The AMSA is responsible to determine the eligibility criteria for care under 38 U.S.C. 1703, 1725, &1728 which determines the VA responsibility for coverage on emergent care. The AMSA is responsible for the proper timely notification to local outside facilities for veterans in their care and to track and obtain documentation until discharge. Proper cost estimates are required based on DRG/ALOS or type of care provided outside the Medicare Rate. This position includes payment reconciling for Community Care medical claims submitted for payment due to outsourcing of treatment for VA Hudson Valley Health Care patients in emergent situations as well as outpatient requests. The AMSA is responsible for veterans referred for care in the community under the Geriatric and Extended Care Programs, Dialysis Program or the DOD Sharing Agreement. The AMSA works closely with the Community Care clinical team to assure all requirements are met. The AMSA is responsible for handling customer service complaints regarding scheduling, care provided, or payment issues by either the veteran or the vendor. The AMSA will work with the outside vendor or veteran and assist with their complaint to an appropriate resolve. Researches and documents the decisions made either by report of contact and/or documentation in clinical tracking. The AMSA is responsible for scanning, verifying, processing authorizations, and scheduling appointments as part of the Community Care Coordination Process. Work Schedule: Monday through Friday 8:00 a.m. - 4:30 p.m. Virtual: This is not a virtual position. Functional Statement #: 21Q64-A 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. Must be proficient in written and spoken English. 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. Must pass pre-employment physical examination. 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 Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Experience and Education. Experience. Six months experience of clerical, office, [customer service], or other [administrative] work that indicates the ability to acquire the particular knowledge and skills needed to perform the duties of the position; OR Education. One year above high school; OR Experience/Education Combination. Equivalent combination of experience and education are qualifying for entry level for which both education and experience are acceptable. Certification. None required. May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grade Determinations: Medical Support Assistant (Advanced) GS-6 Experience. One year of experience equivalent to the [GS-5] grade level. Assignment. The Advanced MSA [provides specialized and expert administrative patient support while working] collaboratively in an interdisciplinary coordinated care delivery model. [Work involves specialized administrative judgment and the flexible use of a wide range of clinical flow processes relating to access to care across multiple clinics, specialties, and/or care in the community resources. Recommends changes to existing clinic procedures based on current administrative guidelines. Expertise in utilizing numerous advanced patient systems in support of multiple clinics involved in an interdisciplinary coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability utilization to ensure that clinic schedules are closely monitored to effectively support the needs of the clinics, and [makes adjustments as 7 necessary. MSAs at this level develop and/or maintain effective and efficient communication with the patient, interdisciplinary coordinated care delivery model teams, VA medical centers, and other agencies (e.g., assist with communications during the inpatient to outpatient discharge; communicate with non-VA medical facilities; prepare correspondence to notify patients of normal lab results; manage a system for follow-up care such as consults, tests, etc.). Other assignments at this level include, but are not limited to: [processes incoming patient secure messaging through MyHealthyVet and coordinates with care team as appropriate; participates in team huddles and team meetings to manage, plan, [problem solve, and follow-up with patient care by sharing information and collaborating with the interdisciplinary team; setting priorities and deadlines, adjusting the flow and sequencing of the work to meet team and patient needs; identifies incomplete encounters and communicates findings to providers; as needed; assists the team to reinforce the plan of care and self-help solutions; enters appropriate information into the electronic record; monitors pre- appointment information and/or requirements to assure readiness for patient visit/procedure; manages patient systems to verify and validate accuracy and resolve issues; evaluates patient information and clinic schedule lists to determine whether the patient requires an immediate appointment; informs team members about shared patients ([i.e]., those who receive their care at multiple VA centers or those who receive care in the community). For all [assignments above the full performance level, the higher-level duties must consist of significant scope, administrative independence, complexity (difficulty), and range of variety as described in this standard at the specified grade level and be performed by the incumbent at least 25% of the time. Demonstrated Knowledge, Skills, and Abilities. Candidates must demonstrate all of the KSAs below: i. Ability to collaborate and communicate with a wide range of medical clinicians across multiple disciplines (e.g. medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical pharmacists, and nursing staff) to accomplish team goal setting to ensure medical care to patients is met. ii. Ability to independently set priorities and organize work to meet deadlines, ensuring compliance with established processes, policies, and regulations. iii. Ability to communicate tactfully and effectively, electronically, by phone, in person, and in writing, with internal and external customers. This may include preparing reports in various formats and presenting data to various organizational levels, as well as resolving patient concerns. iv. Advanced knowledge of the technical health care process (including, but not limited to, scheduling across interdisciplinary coordinated care delivery and/or care in the community models and patient health care portals) as it relates to access to care. v. Advanced knowledge of policies and procedures associated with interdisciplinary coordinated care delivery and/or care in the community operational activities that affect patient flow, and patient support care administrative functions to include, but not limited to appointment cycles, outside patient referrals, follow-up care, overbooking, provider availability, etc. vi. Advanced knowledge of medical terminology due to the technical nature of language utilized by clinicians. Preferred Experience: See VA Directive and Handbook 5019. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.The full performance level of this vacancy is GS-6. Physical Requirements: See VA Directive and Handbook 5019. English Language Proficiency. MSAs must be proficient in spoken and written English in accordance with VA Handbook 5005, Part II, Chapter 3, Section A, paragraph 3.j. Education IMPORTANT: 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 Receiving Service Credit or Earning Annual (Vacation) Leave: Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed. During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions. This job opportunity announcement may be used to fill additional vacancies. This position is in the Excepted Service and does not confer competitive status. VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority. Pursuant to VHA Directive 1193.01, VHA health care personnel (HCP) are required to be fully vaccinated against COVID-19 subject to such accommodations as required by law (i.e., medical, religious or pregnancy). VHA HCPs do not include remote workers who only infrequently enter VHA locations. If selected, you will be required to be fully vaccinated against COVID-19 and submit documentation of proof of vaccination before your start date. The agency will provide additional information regarding what information or documentation will be needed and how you can request a legally required accommodation from this requirement using the reasonable accommodation process. 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.