Health System Specialist (Credentialing and Privileging)
Veterans Affairs, Veterans Health Administration
Summary The Health System Specialist -Credentialing and Privileging Specialist is assigned to the Medical Staff Office, which is under the Chief of Staff at a VA Medical Center (VAMC) and is responsible for providing administrative and technical direction and support to the credentialing and privileging (C&P) operations. Responsibilities This position involves a multi-grade career ladder. The major duties listed below represent the full performance level of GS-09, however a selection can be made at any of the following grade levels: GS-07 OR GS-09. At the GS-07 grade level, you will perform assignments of a more limited scope and with less independence, progressively acquiring the background necessary to perform at the full performance level of GS-09. The C&P Specialist is aligned to and supervised by the C&P Manager. The incumbent ensures compliance with VHA policies, directives, memos and notices of 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. The incumbent is responsible for collecting relevant data and making informed decisions to ensure qualified health care professionals are providing appropriate care in appropriate settings. Major duties include, but are not limited to: Performing as the subject matter expert (SME) to Licensed Independent Providers (LIPs) and Service Chiefs regarding routine and complex matters related to C&P. Assisting the C&P Manager/Analyst in developing short- and long-term goals necessary to accomplish the mission of the C&P program. Assisting the C&P Manager/Analyst in drafting local credentialing processes and Medical Staff Bylaws in compliance with all applicable regulations. Receiving and reviewing VetPro reports detecting problem areas requiring further investigation. Informing the C&P Manager/Analyst of trends identified, audit results and identified problems that may affect a provider's privilege status. Providing guidance and instruction to hospital staff in completing the required documentation of establishing privileges for LIPs. Assuring application packages and other documents meet technical requirements per specialty of provider and assures application folder and database account (VetPro or other internal databases and spreadsheets) meet technical requirements. Serving as technical advisor to the Executive Committee of the Medical Staff (ECMS) and if applicable the Credentials Committee. Developing and providing routine and special reports as requested by the C&P Manager/Analyst. Establishing and maintains a variety of files and records pertaining to the C&P process. 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; 8:00a.m. to 4:30p.m. (PST) Telework: Not Authorized Virtual: Not Authorized Position Description Title/PD#: Health System Specialist (Credentialing and Privileging)/PD99876S and PD99620S 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 require normal safety precautions typical for offices and meeting rooms. The work area is adequately lighted, heated, and ventilated. 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 specialized experience requirements within 30 days of the closing date of this announcement, 02/10/2025. To qualify for this position at the GS-7 level, you must meet one of the following: Specialized Experience: You must have at least one (1) full year of specialized experience, equivalent to the next lower grade level (GS-5) in Federal Service, that equipped you with the particular knowledge, skills, and abilities to successfully perform the duties of a Health System Specialist - Credentialing and Privileging Specialist at a developmental level, and that is typically in or related to the work of the position to be filled. Your experience must show 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. Examples of specialized experience would typically include, but is not limited to: Knowledge of medical terminology, medical specialties and core privileges and procedures to assure competence/appropriateness of credentials and privileging requested; Skill in using software applications such as word processing and data bases and internet database applications for data entry, file maintenance and data retrieval and analysis; Attention to detail required; Ability to communicate orally technical information to a diverse group of individuals with varying levels of understanding. Knowledge of the contacts required for verification of information in health care provider files. NOTE: Experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. ~OR~ Education: PLEASE SEE EDUATION FOR DETAILS ~OR~ Combination: PLEASE SEE EDUATION FOR DETAILS ~OR~ Superior Academic Achievement (SAA): PLEASE SEE EDUATION FOR DETAILS To qualify for this position at 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 the next lower grade level (GS-7) in Federal Service, that equipped you with the particular knowledge, skills, and abilities to successfully perform the duties of a Health System Specialist - Credentialing and Privileging, and includes performing duties associated with healthcare credentialing and privileging. Your experience must show 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. Examples of specialized experience would typically include, but is not limited to: Knowledge of medical terminology, medical specialties and core privileges and procedures to assure competence/appropriateness of credentials and privileging requested; Skill in using software applications such as word processing and data bases and internet database applications for data entry, file maintenance and data retrieval and analysis; Attention to detail required to analyze applications, documents, files and other material pertaining to the Credentialing and Privileging program; Ability to send items back with directions on what is missing or with suggestions and recommendations for changes or improvements; Knowledge of the contacts required for verification of information in health care provider files; Ability to manage multiple projects and priorities and meet deadlines. NOTE: Experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. ~OR~ Education: PLEASE SEE EDUATION FOR DETAILS ~OR~ Combination: PLEASE SEE EDUATION FOR DETAILS You will be rated on the following Competencies for this position: Communications Compliance Quality Assurance Technical Competence 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. 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. GS-07 - Education: Successful completion of one (1) full year of graduate education. Such education must demonstrate the knowledge, skills, and abilities necessary to do 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: Copies of transcripts must be submitted with your application materials. Education cannot be credited without documentation. ~OR~ Combination: Combinations of successfully completed graduate level education and specialized experience, as described above, to meet the total requirements. The education portion must include graduate courses that demonstrate the knowledge, skills, and abilities necessary to do the work of this position (i.e. hospital administration, public health administration, or related fields such as course work in health care administration). Only education beyond a bachelor's degree may be used to qualify applicants for the GS-07 level. NOTE: Copies of transcripts must be submitted with your application materials. Education cannot be credited without documentation. ~OR~ Superior Academic Achievement (SAA): SAA at the baccalaureate level in the coursework detailed above is fully qualifying. Applicants who wish to apply under this provision must submit proof from their educational institution that they meet one of the criteria listed below. To qualify for SAA, applicants must have completed all the requirements for a bachelor's degree in a curriculum that is qualifying for the position to be filled and meet one of the following: Rank in the upper one-third of your class in the college, university or major subdivision. A grade-point average of "B" (a GPA of 2.95 or higher out of a possible 4.0) for all completed undergraduate courses, or those completed in the last two years of undergraduate study. A grade point average of "B+" (a GPA of 3.45 or higher out of a possible 4.0) for all courses in your major field of study, or those courses in your major completed in the last two years of undergraduate study. Membership in a national honor society (other than freshman honor societies) recognized by the Association of College Honor Societies. For a list of recognized honor societies please visit http://www.achsnatl.org/quick\_link.asp. For more information regarding SAA please visit http://www.opm.gov/qualifications/SEC-II/s2-e5.asp#e4f. GS-09 - Education: Successful completion of 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. if related. Such education must demonstrate the knowledge, skills, and abilities necessary to do 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: Copies of transcripts must be submitted with your application materials. Education cannot be credited without documentation. ~OR~ Combination: Combinations of successfully completed graduate level education (beyond the first year) and specialized experience, as described above, to meet the total 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). NOTE: Copies of transcripts must be submitted with your application materials. Education cannot be credited without documentation. Additional Information 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. 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. Participation in the seasonal influenza program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). It is a requirement that all HCP to receive annual seasonal influenza vaccination or obtain an exemption for medical or religious reasons. Wearing a face mask is required when an exemption to the influenza vaccination has been granted. HCP in violation of this directive may face disciplinary action up to and including removal from federal service. HCP are individuals who, during the influenza season, work in VHA locations or who come into contact with VA patients or other HCP as part of their duties. VHA locations include, but are not limited to, VA hospitals and associated clinics, community living centers (CLCs), community-based outpatient clinics (CBOCs), domiciliary units, Vet centers and VA-leased medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation, full- and part-time employees, intermittent employees, fee basis employees, VA contractors, researchers, volunteers and health professions trainees (HPTs) who are expected to perform any or all of their work at these facilities. HPTs may be paid or unpaid and include residents, interns, fellows and students. HCP also includes VHA personnel providing home-based care to Veterans and drivers and other personnel whose duties put them in contact with patients outside VA medical facilities. The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced VA competitive service employees with selection priority over other candidates for competitive service vacancies. To be well-qualified, applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors if applicable, and must be proficient in most of the requirements of the job. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website which can be found at https://www.opm.gov/. 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.
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