The incumbent serves as a Health Systems Specialist (Credentialing and Privileging Manager) and is assigned to the Medical Staff Office, which is under the Chief of Staff (COS) at a VAMC. The incumbent oversees all functions related to healthcare providers' professional credentials supporting all divisions of the VAMC in accordance with VHA Credentialing and Privileging (C&P), Directives, VA Handbooks, Policies, Memos, and Notices.
To qualify for this position, applicants must meet all requirements within 30 days of the closing date of this announcement, 05/20/2025. 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 within 30 days of the closing date of this announcement. For a GS-11 position you must have served 52 weeks at the GS-09. 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. 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. 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-09 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 government-wide, agency and facility systems and requirements in the area of credentialing/privileging to recognize problems or issues and to make substantial recommendations to the appropriate offices; Knowledge of VetPro policies and of pertinent laws, regulations, policies and precedents; accreditation standards and guidelines; Skilled in research of data, policies, legal issues; Experienced in applying analytical and evaluative methods and techniques to issues or studies to be incorporated into program directives covering new and innovative conceptual approaches and methods for enhancing the assessment of current competence and quality of care provided and identification of areas for improvement. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have successfully completed a Ph.D. or equivalent doctoral degree or 3 full years of progressively higher level graduate education leading to such a degree or LL.M., 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). The education portion must include courses that demonstrate the knowledge, skills, and abilities necessary to do the work of this position. Education must have been obtained in an accredited college, or university. NOTE: Transcripts must be submitted with your application materials. Education cannot be credited without documentation. OR, Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond graduate level. Combining may be computed by first determining the applicant's total qualifying experience as a percentage of the experience required for the grade level; then determining the applicant's education as a percentage of the education required for the grade level; and then adding the two percentages. The total percentages must equal at least 100 percent to qualify an applicant for that grade level. Only graduate education in excess of the amount required for the next lower grade level may be used to qualify applicants for positions at grades GS-9 and GS-11. (When crediting education that requires specific course work, prorate the number of hours of related courses required as a proportion of the total education to be used.) You will be rated on the following Competencies for this position: Administration and Management Interpersonal Skills Leadership 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. Physical Requirements: The work is sedentary, although some slight physical effort may be required. 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/.
Duties include but are not limited to: Provides direct technical and administrative supervision to employees in the Credentialing Office. Manages staff performance by setting and adjusting short and long-term priorities; assesses staffing needs; plans work to be accomplished. Develops, modifies, and/or interprets performance standards; outlines and explains performance expectations to staff. Provides advice, counsel, and instruction to employees on work and administrative matters. Identifies developmental and training needs of employees and provides/arranges for needed development and training. Provides consulting and guidance to local leadership and credentialing employees on all matters pertaining to the credentialing program. Attends committee meetings and presents providers' credentials, clinical practice histories and red flags. Performs as the subject matter expert for credentialing updates to Human Resources, providers and hiring services. Attends meetings, conferences and seminars to assist with the identification of areas needing improvement. Interprets and explains new regulatory requirements, procedures and processes. Reviews clinical privileges and scope of practices for accuracy, setting specific indicator and signature appropriations as required for compliance. Ensures all mandatory reviews and recommendations are documented in an electronic credentialing database. Leads external and internal regulatory and accrediting investigation issues surrounding credentialing, privileging, and/or reporting. Assists with developing, coordinating and recommending changes for the improvement of workflow in the program or section area Manages query submissions and results; ensures that primary source verifications are obtained and processed via quality control review. Identifies and presents to leadership the resources necessary for accomplishing the mission and function of the credentialing program. Implement mechanisms to monitor and evaluate completed tasks for their compliance with established policies and procedures. Develops and utilizes analytical and diagnostic tools to identify, evaluate, and recommend to management techniques for developing new or modified work methods. Validates processes that are working efficiently and according to plan to identify dysfunctional process issues as early as possible during the implementation phase. Uses cost-effectiveness, cost-benefit, and cost-utility analyses in programmatic prioritization and decision making. Work Schedule: Monday - Friday 7:30AM - 4:30 PM Virtual: This is not a virtual position. Position Description/PD#: Health Systems Specialist (Credentialing and Privileging Manager)/PD99875S Relocation/Recruitment Incentives: May be Authorized Critical Skills Incentive (CSI): Not Authorized