Health System Specialist (Credentialing & Privileging Specialist) - Detroit Michigan

Company: Veterans Affairs, Veterans Health Administration
Location: Detroit, Michigan
Posted On: 04/18/2024

Summary Responsible for providing administrative and technical direction and support to the credentialing and privileging (C&P) operations. Ensures compliance with VHA policies, directives, memos and notices of The Joint Commission (TJC) standards. Responsible for collecting relevant data and making informed decisions to ensure qualified health care professionals are providing appropriate care in appropriate settings. Responsibilities 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 8:00 am - 4:30 pm Telework: Available. VA supports the use of telework as a way to help attract and retain talented individuals in public service, increase worker productivity, and better prepare the agency to operate during emergencies. This position may be authorized for telework. Telework eligibility will be discussed during the interview process. Virtual: This is not a virtual position. Position Description/PD#: Health System Specialist (Credentialing & Privileging Specialist)/PD99876 and PD99620 Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required 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. Physical Requirements: Work is primarily sedentary. Occasionally, light physical effort may be required, such as that involved with walking, stair climbing, and carrying of light office items. Qualifications To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 03/27/2024. 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-07 position you must have served 52 weeks at the GS-05. For a GS-09 position you must have served 52 weeks at the GS-07. 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. Individual Occupational Requirement: To meet the basic qualification of the 0671 Health System Administration Occupational Series: Possess an undergraduate or graduate level degree with a major study in hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration; OR, Possess 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, Completed an agency-sponsored on-the-job training program that was a formal individualized training plan within a 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); and Oversight by an experienced health system administrator with periodic evaluation of the individual's progress and appropriate adjustment of the training program. *Proof of successful completion of an agency-sponsored on-the-job training program is required. In addition to meeting the Individual Occupational Requirement (IOR), you may qualify based on your experience and/or education as described below: GS-07 Experience and/or Education: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-05 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: analytical or administrative experience in the health care field; administrative clerical support duties, reviewing and developing reports, composing correspondence and memos, and providing staff assistance and advice on administrative matters; collecting relevant data and making informed decisions to ensure qualified health care professionals are providing appropriate care in appropriate settings; knowledge of pertinent laws, regulations, policies and precedents, accreditation standards and guidelines; knowledge of the contacts required for verification of information in health care provider files; utilizing medical terminology, medical specialties and core privileges and procedures to assure competence/appropriateness of credentials and privileging requested; OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have one (1) full year of graduate level education or superior academic achievement. GS-09 Experience and/or Education: 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: analytical or administrative experience in the health care field; applying analytical and evaluative methods and techniques to issues or studies concerning the efficiency and effectiveness of operations; advising leadership on documentation requirements for provider profiling and competence; providing technical information to a diverse group of individuals with varying levels of understanding; using monitoring and tracking strategies for critical reports such as time limited certification, registrations, and/or licensures, clinical privileges, and appropriate access for facility and shared facility users; collecting relevant data and making informed decisions to ensure qualified health care professionals are providing appropriate care in appropriate settings; broad and thorough knowledge of pertinent laws, regulations, policies and precedents, accreditation standards and guidelines; knowledge of the contacts required for verification of information in health care provider files; utilizing medical terminology, medical specialties and core privileges and procedures to assure competence/appropriateness of credentials and privileging requested. Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a masters or equivalent graduate degree or 2 full years of progressively higher-level graduate education leading to such a degree, OR, a related LL.M or J.D to the work of the position. Combination Experience/Education: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond one (1) year of graduate education. To calculate, first identify the percentage of required education you have earned (when substituting, you cannot use the first year of graduate education). Then identify the percentage of required experience you possess. Add the two percentages. The total percentage must equal at least 100 percent to qualify. 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 Education A transcript must be submitted with your application if you are basing all or part of your qualifications on education. If you are basing your qualifications on education (or a combination of education and experience) or if the position requires a college education to qualify, you must submit a copy of your transcripts with your application. Your official or unofficial transcript must reflect: name of the college or university, full address of the college or university, your name, class title(s) with the number of credits earned/completed, the degree received, if applicable, and date degree conferred. A copy of your certificate/degree or screenshot of your current classes are not a replacement of your transcript and they will not be used in the qualifying process. 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: 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: Additional Information The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced Federal/VA competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation (a copy of the agency notice, your most recent performance rating, and your most recent SF-50 noting current position, grade level, and duty location) and be found well-qualified for this vacancy. To be well-qualified: applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the required competencies of the job. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website at This job opportunity announcement may be used to fill additional vacancies. 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.
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