The Caregiver Support Program (CSP) is one of the Veterans Health Administration's (VHA) most rapidly growing service areas. CSP expansion puts the VHA into the role of healthcare system pioneer-caring directly for the caregiver. The Physician (Caregiver Support Program) Centralized Eligibility and Appeal Team, works in the VISN-level Centralized Eligibility Team (CEAT).
To qualify for this position, you must meet the basic requirements as well as any additional requirements (if applicable) listed in the job announcement. Applicants pending the completion of training or license requirements may be referred and tentatively selected but may not be hired until all requirements are met. Currently employed physician(s) in VA who met the requirements for appointment under the previous qualification standard at the time of their initial appointment are deemed to have met the basic requirements of the occupation. 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. Degree of doctor of medicine or an equivalent degree resulting from a course of education in medicine or osteopathic medicine. The degree must have been obtained from one of the schools approved by the Department of Veterans Affairs for the year in which the course of study was completed. Current, full and unrestricted license to practice medicine or surgery in a State, Territory, or Commonwealth of the United States, or in the District of Columbia. Residency Training: Physicians must have completed residency training, approved by the Secretary of Veterans Affairs in an accredited core specialty training program leading to eligibility for board certification (Primary Care Medicine, Internal Medicine, PM&R or Geriatrics). (NOTE: VA physicians involved in academic training programs may be required to be board certified for faculty status.) Approved residencies are: (1) Those approved by the Accreditation Council for Graduate Medical Education (ACGME), b) OR (2) Those approved by the American Osteopathic Association (AOA),OR (3) Other residencies (non-US residency training programs followed by a minimum of five years of verified practice in the United States), which the local Medical Staff Executive Committee deems to have provided the applicant with appropriate professional training and believes has exposed the physician to an appropriate range of patient care experiences. Residents currently enrolled in ACGME/AOA accredited residency training programs and who would otherwise meet the basic requirements for appointment are eligible to be appointed as "Physician Resident Providers" (PRPs). PRPs must be fully licensed physicians (i.e., not a training license) and may only be appointed on an intermittent or fee-basis. PRPs are not considered independent practitioners and will not be privileged; rather, they are to have a "scope of practice" that allows them to perform certain restricted duties under supervision. Additionally, surgery residents in gap years may also be appointed as PRPs. English Language Proficiency: Proficient in spoken and written English Preferred Experience: Board Certified in Primary Care Medicine, Internal Medicine, PM&R or Geriatrics. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Physical Requirements: This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. The work requires occasional periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing.
The Centralized Eligibility and Appeal Team (CEAT) is responsible for reviewing complex PCAFC eligibility cases for admission, ongoing level of care adjustments, and discharge appropriateness. The CEAT is also responsible for adjudicating PCAFC applicant and participant first-level appeals sent from other CEATs, within the same region, and second-level appeals sent by CEATs based in other regions of the country. Major duties include, but are not limited to: Serves as a core member of a VISN-level Centralized Eligibility Team. Adjudicate first-level appeals for alternate VISN CEATs and second-level appeals for one of the other three CEAT Regions. Review Veteran's medical record summary, most recent History & Physical, findings of recent testing at the facility, caregiver assessment and care team input. Interpret trends and patterns, application of regulation, policy, guidelines. Maintain understanding of eligibility associated with VA service connection and conducts review of eligibility documents, as needed, to determine whether service connected condition meets eligibility requirement. Utilize knowledge of PCAFC clinical eligibility to coordinate with other regional CEATs the transfer of appeals for inter-VISN evaluation. Receive, review, and dispositions PCAFC initial eligibility decisions; reassessments; and appeal decisions for clinical eligibly determinations. Ensure alignment of local and regional policy under Directive 1152(1) and the Mission Act. Completes all reports, data, and maintain logs with outcome of meetings related to the CSP Program. Analyze data obtained in record review for use in determining clinical eligibility for PCAFC. Document information utilized in clinical eligibility determination and eligibility assessment tools. VA offers a comprehensive total rewards package. VHA Physician Total Rewards. Pay: Competitive salary, annual performance bonus, regular salary increases Paid Time Off: 50-55 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year and possible 5 day paid absence for CME) Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Licensure: 1 full and unrestricted license from any US State or territory CME: Possible $1,000 per year reimbursement (must be full-time with board certification) Malpractice: Free liability protection with tail coverage provided Contract: No Physician Employment Contract and no significant restriction on moonlighting Telework: Ad-hoc telework - only when official duty station is closed due to emergency situations, inclement weather, etc. Relocation/Recruitment Incentives: Not Authorized Work Schedule: Monday through Friday, 8:00 am - 4:30 pm