This position is located at the Fayetteville VA Medical Center in Fayetteville, NC. The Health System Specialist (Credentialing & Privileging) 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. The C&P Specialist is responsible for the C&P process of VAMC clinical services providers.
To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 05/01/2025. 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-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. You may qualify based on your experience and/or education as described below: 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: Knowledge of the relationship between Quality Assessment and Improvement (QA&I), Risk Management, Patient Assistance, and Credentialing and Privileging functions; Knowledge of skill in interpreting and applying technical QA&I, Risk Management, and Credentials/Privileging data, regulations, policy statements, and other guidance materials; Skill in applying analytical and evaluative methods and techniques to issues or studies concerning the efficiency and effectiveness of the credentialing and privileging operations and toward the planning and accomplishment of a variety of difficult and complex work assignments, such as advising leadership on documentation requirements for provider profiling and competence; Communication skills and ability to communicate complex and highly technical information to a diverse and regional customer group; Knowledge of the contacts required for verification of information in health care provider files; Comprehensive knowledge of medical terminology, medical specialties and core privileges and procedures to assure competence/appropriateness of credentials and privileging requests; Knowledge of English grammar, spelling, punctuation, syntax, and required formats necessary to prepare official correspondence, documents, and minutes; and Skill in using software applications such as word processing and data bases and internet database applications for data entry, file maintenance and data retrieval. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree. OR, Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and graduate education beyond the 4-yr college degree. You will be rated on the following Competencies for this position: Communications Compliance Quality Assurance Technical Competence Preferred Experience: current Credentialing & Privileging experience. 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 sedentary, although some slight physical effort may be required. The work is primarily in an office setting. 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/.
The incumbent assists the C&P Manager/Analyst in developing short- and long-term goals necessary to accomplish the mission of the C&P program. Assists in identifying the resources necessary for accomplishing the mission and function of the credentials and privileging program. Serves as SME in the field of credentials and clinical privileging. Keeps leadership and appropriate administrative staff informed of program changes, new regulatory requirements, and policies and procedures pertaining to the C&P process. Assists C&P Manager/Analyst in drafting local credentialing processes and Medical Staff Bylaws in compliance with all applicable regulations. Ensures accurate provider data is entered into and maintained in the VetPro computer program. Ensures current information is present on providers relative to state licensure, Drug Enforcement Organization (DEA) license, National Practitioner Data Bank (NPDB) Continuous Query (CQ) enrollments and renewals, Federation of State Medical Boards (FSMB), documentation of professional education, specialty medical training, certifications, adverse licensure or privileging actions, initial and renewal of privileges which may affect the status of privileges granted for medical practice. Informs C&P Manager/Analyst of trends identified, audit results and identified problems that may affect a provider's privilege status. Manages provider applications (initial and renewals) for LIPs C&P within the VAMC. Incumbent must have a broad knowledge of medical specialties and core privileges and is the technical advisor to clinical leadership for the development of department specific privileges and assures that complete documentation is available to support privileges granted to providers within their training and/or experience. Provides guidance and instruction to hospital staff in completing the required documentation of establishing privileges for LIPs. Upon receipt of individual credentials' files for review, incumbent ensures primary source verification to include, but not limited to, state licenses, DEA license, certifications, medical specialty training, and board certifications. Coordinates with clinical service departments on findings of clinical care competency. Assures 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. Communicates with LIPs to assure timely completion of applications and VetPro requirements. Provides oversight to application process; analyzes exceptions and deviations in expected application process; determines course of action and makes recommendations. Determines processes for coordination of incoming data and documents from a variety of sources. Work Schedule: Monday-Friday, 8:00a-4:30p Position Description/PD#: Health System Spec (Credentialing & Privileging Spec)/ 99876-S