The Health System Specialist, VISN 8 Business Development Officer (BDO), provides expert knowledge of VHA policies in all matters involving these essential programs and is responsible for planning, developing and executing actions to ensure business operations and systems that are patient centric, standardized and coordinated across all VISN 8 Healthcare Systems, Medical Centers, community outpatient clinics and community healthcare affiliates.
To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 11/12/2025. 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-14 position you must have served 52 weeks at the GS-13. 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): The 0671 series requires specific education or experience to be met in order to be appointed into a position of this series. You must meet one of the pre-determined Education or Experience Individual Occupational Requirements listed below as set by Office of Personnel Management (OPM). Education: Undergraduate and Graduate Education in a Major study of hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. - OR - Experience: Experience of 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: 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. 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); and Oversight by an experienced health system administrator with periodic evaluation of the individual's progress and appropriate adjustment of the training program. GS-13 Grade Level Requirement - In addition to the Time in Grade and the Individual Occupation Requirement, you must have the specialized experience below. You may qualify based on your experience as described below: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-13 in the normal line of progression for the occupation in the organization. Examples of specialized experience include, but are not limited to: Comprehensive knowledge of Medical/Health Administration and Health Information Management specialized knowledge of the principles and practices related to the management of health care delivery systems regarding patient intake (Enrollment and Eligibility, revenue, Non-VA Care and Health Information Management to support decision making and program oversight), appointment scheduling and clinic grid management including management of wait lists, patient information including demographics and patient health information; in-depth understanding of non-VA care including the Veterans Choice and Choice First Programs in order to act as a liaison with the CBO staff; Thorough knowledge of all established laws, regulations and the VA, VHA VISN, and local policies to operate under the (VISN, Medical Center policies, VHA Directives and external guidelines issued by bodies such as CMS pertaining to eligibility, Means Test, ICD-10 coding, Tort Feasors as well as a wide range of MCCF and NVCC guidelines); Skill in applying fact finding and investigative techniques to identify, analyze and recommend solutions to strategic, operational, management and organizational issues; Knowledge of the different managers/staff functions and impulses of the seven diverse facilities for four major programs, in order to gather information present recommendations, and coordinate services; and monitor work based on performance measures and assist managers in designing reporting process; and advising Pentad members of these seven facilities in reshaping processes to assure work meets or exceeds expectation/performance measures; Knowledge of Insurance regulations and criteria of various billing, collection, reimbursement, and monitoring; Tricare/DOD and other related billing carries to resolve contradictory requests in coordinating and formulating recommendations for clinical and administrative services; Knowledge of the exclusive features of the explicit health care delivery system of Tricare-scope of contracts and coordination of benefits, CHAMPVA, other sharing resource agreements and Network "alternative revenue streams"; and must understand patient processing, billing and collections, software and business processes for Tricare; and have knowledge of business practices of the healthcare industry to review obtained data, identify coding and other errors, in order to maximize the insurance billing and collection. You will be rated on the following Competencies for this position: Administration and Management Customer Service (Clerical/Technical) Planning and Evaluating 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 mostly sedentary with no special physical requirements. 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/.
This job opportunity NTE 1 year may result in a detail or temporary promotion which may become permanent without further competition. Major duties include, but are not limited to the following: Leads business operations related to administration of health benefits and patient administration activities Identifies requirements for funding, staffing, space, privacy and technology o support business programs and delivery of services to veterans across geographical areas in VISN 8. Leads standardization and improvement efforts of business processes that support desired outcomes, productivity, efficiency, and access for VISN. Serves as a subject matter expert in the administration of healthcare benefits and regularly collaborates and communicates with an array of internal and external stakeholders, including Veterans and their family and caregivers, admin and clinical employees across services, VSO leaders, community organizations, local governments, along many other external stakeholders. Communicates with academic affiliates, community providers, and third party payers, the incumbent conjointly works with Network clinical leadership in building a Care Coordination Network Model complementing VA providers with preferred community providers, selected for meeting quality and customer service standards and having values aligned with VHA to include a point of service option where Veterans elect other providers. Serves on national task groups, both voluntarily and as requested, designed to develop and implement national policy. Also, chairs and/or co-chairs VISN-level committees such as the Beneficiary Travel Committee, Non-MCCF Committee and HAS Chiefs Committee. Develops strategy and actions and provides strategic oversight for business operations in the area of medical administration, revenue, beneficiary travel, scheduling, patient intake, enrollment/eligibility, and special programs. Develops, redesigns and streamlines administrative services that are "Human-Centered" and designed to support Veterans beliefs, attitudes, behaviors as they relate to the tasks the system is being designed to support so that the outcomes of new systems are greater efficiency, satisfaction, user friendliness and maximized efficiencies. Manages the development, enhancement, analysis, standardization, monitoring, and identification of operational administrative and clinical procedures and practices across the Network that meets all technical and regulatory requirements for the programs managed. Work Schedule: Monday - Friday, 8:00am - 4:30pm Telework: This position may be authorized ADHOC telework for a highly qualified candidate. Virtual: This is not a virtual position. Position Description/PD#: Health System Specialist (VISN 8 Business Development Officer) (Detail/Temp Promo NTE 1 Year)/PD10913A Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required