Subject matter expert (SME) to Licensed Independent Practitioner and Service Chiefs regarding routine and complex matters related to C&P including provider competence for provider practice evaluation (OPPE) and focused provider practice evaluation. Ensuring compliance with policies, directives, memos and notices of The Joint Commission standards, recommendations by the Office of Inspector General (OIG) and Government Accountability Office (GAO) and other auditors and reviewers as appropriate.
To qualify for this position, applicants must meet all requirements within 30 days of the closing date of this announcement, 05/08/2025. 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-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. 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. You may qualify based on your experience and/or education as described below: Specialized Experience: You must have at least one (1) full year of specialized experience, equivalent to the next lower grade level (GS-7) in Federal Service, that equipped you with the particular knowledge, skills, and abilities to successfully perform the duties of a Health System Specialist - Credentialing and Privileging, and includes performing duties associated with healthcare credentialing and privileging. Your experience must show 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. Examples of specialized experience would typically include, but is not limited to: Broad and thorough knowledge of pertinent laws, regulations, policies and precedents, accreditation standards and guidelines; Comprehensive knowledge of VetPro policies, including but not limited to, VetPro Data Integrity, Facility level access control, mandatory annual VetPro security and confidentiality training, and mandatory annual privacy act training; Skill in applying analytical and evaluative methods and techniques to issues or studies concerning the efficiency and effectiveness of the C&P operations, such as advising leadership on documentation requirements for provider profiling and competence. Ability to manage multiple projects and priorities and meet deadlines. Note: Experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. OR, Education: Successful completion of a master's or equivalent graduate degree, successfully completed two (2) full years of progressively higher level graduate education leading to such a degree, LL.B or J.D. 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). Note: Copies of transcripts must be submitted with your application materials. Education cannot be credited without documentation. OR, Combination: Combinations of successfully completed graduate level education (beyond the first year) and specialized experience, as described above, to meet the total requirements. The education portion 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: Copies of transcripts must be submitted with your application materials. Education cannot be credited without documentation. Preferred Experience: Medical Staff Office experience of 1.5+ years; experience with utilizing government purchase cards and performing reconciliations; knowledge of credentialing and privileging rules, regulations, and national standards. Familiarity with database management and web-based software utilities. Knowledge of licensure and certification renewal process. You will be rated on the following Competencies for this position: Communications Compliance 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. 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/.
Major duties include, but are not limited to: Performing as the subject matter expert (SME) to Licensed Independent Providers (LIPs) and Service Chiefs regarding routine and complex matters related to C&P. Assisting the C&P Manager/Analyst in developing short- and long-term goals necessary to accomplish the mission of the C&P program. Assisting the C&P Manager/Analyst in drafting local credentialing processes and Medical Staff Bylaws in compliance with all applicable regulations. Receiving and reviewing VetPro reports detecting problem areas requiring further investigation. Informing the C&P Manager/Analyst of trends identified, audit results and identified problems that may affect a provider's privilege status. Providing guidance and instruction to hospital staff in completing the required documentation of establishing privileges for Licensed Independent Providers. Assuring 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. Serving as technical advisor to the Executive Committee of the Medical Staff (ECMS) and if applicable the Credentials Committee. Developing and providing routine and special reports as requested by the C&P Manager/Analyst. Establishing and maintains a variety of files and records pertaining to the C&P process. Work Schedule: 7:30 am - 4:00 pm, Monday to Friday Virtual: This is not a virtual position. Position Description/PD#: Health System Specialist - Credentialing & Privileging/PD99876S Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Physical Requirements and Work Environment: The work is mostly sedentary. Occasionally, light physical effort may be required, such as that involved with walking, stair climbing, and carrying of light office items. The work is performed in an office setting which require normal safety precautions typical for offices and meeting rooms. The work area is adequately lighted, heated, and ventilated.