- Position Title
- Health System Specialist
- Agency
- Veterans Health Administration
- Announcement Number
- CAZX-12709406-25-AS Opens in new window
- Open Period
- Friday, March 14, 2025 to Monday, March 24, 2025
For preview purposes only. To apply, please return to the USAJOBS announcement and click the Apply button.
Eligibilities
1.
Do you claim Veterans’ Preference?
Preferences
1.
Which of the following items describes your current or recent (within the last five years) political appointee service?
If you responded yes to any of the items below, you will need to include a SF-50 specifying your prior service.
If you responded yes to any of the items below, you will need to include a SF-50 specifying your prior service.
Your resume must be submitted in English and include the following information for each job listed:
- Job title Duties (be as detailed as possible)
- Month & year start/end dates (e.g. June 2007 to April 2008)
- Full-time or part-time status (include hours worked per week)
- Series and Grade, if applicable, for all Federal positions you have held
- Please be aware that your answers will be verified against information provided on your resume. Be sure that your resume clearly supports your responses to all of the questions by addressing your work experience in detail.
By submitting your application, you are certifying, to the best of your knowledge and belief, all the information submitted by you with your application for employment is true, complete, and made in good faith, and that you have truthfully and accurately represented your work experience, knowledge, skills, abilities and education (degrees, accomplishments, etc.). The information you provide as part of your application may be investigated. You are also certifying, and acknowledging, that misrepresenting your experience or education, or providing false or fraudulent information in, or with your application, may affect your eligibility for appointment and/or continued employment. False or fraudulent statements may be punishable by fine or imprisonment (18 U.S.C. 1001).
Assessment 1
Select the appropriate answer to each of the following questions based on your current level of education and/or experience that demonstrates your ability to perform the duties of this position. When answering the questionnaire, remember that your experience and education are subject to verification by investigation. You may be asked to provide specific examples or documentation of experience or education as proof to support your answers, or you may be required to verify a response by a practical demonstration of your claimed ability to perform a task.
Select “Yes” or “No” to the following question(s).
1.
Time in Grade (TIG) Requirement: Applicants must meet time-in-grade requirements to qualify for this position. For a GS-11 position, you must have served 52 weeks at the GS-09.
Do you meet the time-in-grade requirement for this position?
Do you meet the time-in-grade requirement for this position?
2.
Specialized Experience Requirement: Do you 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 as stated below?
Specialized Experience:
For a GS-11 Specialized Experience
You must have at least one (1) full year of specialized experience equivalent to at least the next lower grade level (GS-9) in the Federal Service, that is directly related to the work of the position and has equipped you with the particular knowledge, skills and abilities to successfully perform the duties as a Health System Specialist (Integrity Compliance Specialist/Analyst). Qualifying specialized experience is defined as 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:
(1) Missions, organizations, programs, and requirements of health care delivery systems;
(2) Regulations and standards of various regulatory and credentialing groups; and
(3) Government -wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement.
OR,
Education (Transcripts required): Applicants may substitute education for the required experience. 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).
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
an LL.M. if related.
OR,
Combination (Transcripts required): Applicants may also combine education and experience to qualify at this level. You must have equivalent combinations of successfully completed graduate level education (in excess of the first two graduate years or 36 semester hours) and specialized experience to meet total experience requirements. The education must include graduate courses that demonstrate the knowledge, skills, and abilities necessary to do to the work of this position (i.e. hospital administration, public health administration, or related fields such as course work in health care administration).
**Note: If using education to qualify or if using education combined with specialized experience to qualify, a copy of your transcript is required. Education cannot be credited without a transcript.
Specialized Experience:
For a GS-11 Specialized Experience
You must have at least one (1) full year of specialized experience equivalent to at least the next lower grade level (GS-9) in the Federal Service, that is directly related to the work of the position and has equipped you with the particular knowledge, skills and abilities to successfully perform the duties as a Health System Specialist (Integrity Compliance Specialist/Analyst). Qualifying specialized experience is defined as 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:
(1) Missions, organizations, programs, and requirements of health care delivery systems;
(2) Regulations and standards of various regulatory and credentialing groups; and
(3) Government -wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement.
OR,
Education (Transcripts required): Applicants may substitute education for the required experience. 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).
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
an LL.M. if related.
OR,
Combination (Transcripts required): Applicants may also combine education and experience to qualify at this level. You must have equivalent combinations of successfully completed graduate level education (in excess of the first two graduate years or 36 semester hours) and specialized experience to meet total experience requirements. The education must include graduate courses that demonstrate the knowledge, skills, and abilities necessary to do to the work of this position (i.e. hospital administration, public health administration, or related fields such as course work in health care administration).
**Note: If using education to qualify or if using education combined with specialized experience to qualify, a copy of your transcript is required. Education cannot be credited without a transcript.
Select the one statement that most accurately describes your training and experience carrying out each task using the scale provided. When answering the questionnaire, remember that your experience and education are subject to verification by investigation. You may be asked to provide specific examples or documentation of experience or education as proof to support your answers, or you may be required to verify a response by a practical demonstration of your claimed ability to perform a task. For each item, select the one response that most accurately describes your current level of experience and capability using the scale below.
Select the one statement that most accurately describes your training and experience carrying out each task using the scale provided.
3.
Develops programs to ensure that compliance program provisions are planned, developed and implemented to identify, prevent and correct unsatisfactory conditions and elements which influence the regulatory correctness and responsiveness of business and services.
4.
Aligning collaborative working relationships with program coordinators, medical staff, key business operational owners, executive leadership, and other key stakeholders.
5.
Developing recurring trending reports and facilitating the use of auditing tools to evaluate the outcomes from specialized areas for improvement, and to determine weaknesses within a program. Initiates and maintaines the compliance monitoring and auditing plan.
6.
Independently prepares complete reports, summarizes analysis, audit findings, and presents information to multiple forums: Integrity Compliance Officer (ICO), Compliance Committee, Executive Leadership and Operational Business Process Owners.
7.
Reporting on trends and frequency of non-compliance, and developing an analytical data review for monthly and quarterly reports. Pull the data, analyze, train the users on identified inaccuracies and recommend/develop corrective actions to prevent future occurrences.
8.
Initiates investigations on compliance inquiries, allegation fact-findings, ensuring receipt of adequate corrective action plans and following up. All inquires, allegation and non-compliance are entered within CIRTS software.
9.
Completing programmatic auditing of facility-wide revenue operations process and community care.
10.
Processes the reviews through the entire flow of reimbursement and billing to include the following: auditing, internal control effectiveness, performing route cause analysis, identifying areas of improvement, making recommendations of corrective actions, trending, and then follow up.
11.
Works with the compliance committee to identify future risk mitigation activities, enterprise risk management and mitigation plans
12.
Develops recommendations for the facility ICO and Director to use in evaluating risk and ensuring full facility-wide compliance with national directives. Ensures facility risk assessment plan is updated quarterly.
13.
Conducts audits and/or other evaluation techniques to monitor compliance and to assist in the reduction of identified problem areas and support: Risk Assessment Plans, Monitoring and Auditing Plan, and Training/Education Plan as it relates to potential and identified facility risks.
14.
Assist in development of local SOP, Policies and Procedures as appropriate. Monitors and shares new VHA Directives to appropriate operational owners and identify gaps in compliance.
15.
Identifies indicators, progress measures, objectives and emphasis areas that are potentially non-compliant according to the VHA rules and regulations.
16.
Assist establishing programs to develop and implement internal control measures and monitor if there is a high risk of operational failure.
17.
Analyze audit results, writes reports and recommends system changes to the ICO, as appropriate. Provides ICO with written reports of the findings of the audits conducted and works with the key business process owners to complete a Causation, Corrective Action Plan (CCAP) as needed.
Resume Reminder: Your resume must include the following information for each job listed: Job title Duties (be as detailed as possible) Month & year start/end dates (e.g. June 2007 to April 2008) Full-time or part-time status (include hours worked per week) Series and Grade, if applicable, for all Federal positions you have held Please be aware that your answers will be verified against information provided on your resume. Be sure that your resume clearly supports your responses to all of the questions by addressing your work experience in detail. Recommended: Even though we do not require a specific resume format, your resume must be clear so that we are able to fully evaluate your qualifications. To ensure you receive appropriate consideration, please list the duties you performed under each individual job title. If we are unable to match your experiences with the positions held, you may lose consideration for this vacancy. We cannot make assumptions regarding your qualifications.