This position is organizationally aligned under the Office of the Medical Center Director at the Edward Hines Jr. VA Hospital (578), Hines, IL - a complexity level 1a VHA facility. The primary purpose of the position is to function as the Facility Integrity and Compliance Officer (ICO). Salary Ranges: GS 12: $99,069 - $128,795 GS 13: $117,807 - $153,151
To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 06/27/2025. 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-12 position you must have served 52 weeks at the GS-11. For a GS-13 position you must have served 52 weeks at the GS-12. 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. BASIC REQUIREMENTS: You must have one of the following: EDUCATION: Undergraduate or Graduate Education with a major study in hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. OR, 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 Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement You may qualify based on your experience and/or education as described below: GS-12 Grade Requirements: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-11 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Mastery of advanced principles and practices of program management and analytical ability sufficient to conduct comparative studies aimed at determining the effectiveness of a wide range of forms, records, files, management processes, management information system/office automation and the applicability of higher-level directives to a highly complex multi-mission facility. Skill in oral and written communication to prepare and present recommendations and solutions regarding complex issues based on analysis and evaluation, including the preparation and presentation of reports, proposals, charts and graphs, etc. Expert knowledge of the healthcare industry and/or experience with Medicare and third-party payer coding and billing practices. GS-13 Grade Requirements: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-12 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Mastery of advanced principles and practices of program management and analytical ability sufficient to conduct comparative studies aimed at determining the effectiveness of a wide range of forms, records, files, management processes, management information system/office automation and the applicability of higher-level directives to a highly complex multi-mission facility. Skill in oral and written communication to prepare and present recommendations and solutions regarding complex issues based on analysis and evaluation, including the preparation and presentation of reports, proposals, charts and graphs, etc. Expert knowledge of the healthcare industry and/or experience with Medicare and third-party payer coding and billing practices. Expert knowledge of, and skill in using management information system(s), office automation systems and processes, computer applications, principles, and techniques, including ability to develop and implement new automated systems for control and support of interrelated program operations. You will be rated on the following Competencies for this position: Administration and Management Change Management Communications 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: Performance of the employee's duties may require extensive walking per day to meet with Facility Executive Leadership Team, Clinic Leads, Administrative Leads, PAS staff, and other appropriate personnel. Trips to satellite outpatient clinics (CBOCs) are sometimes necessary and will involve transportation via station GSA vehicle or privately-owned vehicle. The work performed is of a precise nature requiring long periods of concentration that is often interrupted. The Incumbent is often faced with changing priorities and with meeting deadlines. 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/.
The primary purpose of the position is to function as the Facility Integrity and Compliance Officer (ICO). Compliance is an oversight process, supported by appropriate organizational conditions (culture, regulations, policies, procedures, controls, etc.) which over time are most likely to ensure that employee actions and character are consistent with VHA core values. The ICO identifies high risk areas and initiates corrective actions. The program must fulfill the Office of Inspector General's (OIG) guidelines for effective compliance programs as well as fulfillment of all VHA regulations, including VHA Directive 1030 (VHA Integrity and Compliance Program) and its accompanying guidebooks. The Facility ICO contributes to the fulfillment of the organization's mission and vision by planning, designing, implementing, and maintaining system-wide compliance programs, policies, and procedures. The Facility ICO is an active member of senior management who reports directly to the Corporate Compliance Officer and provides guidance and counsel on incorporating compliance- related activities into the operations of a complex multi-mission facility. This individual maintains current regulatory resources, ensures regulatory and policy updates are disseminated to employees in a timely manner, performs on- going monitoring of all areas of compliance and acts decisively on issues of potential non-compliance and focusing on fraud, waste and abuse. Develops, implements, and maintains the compliance program throughout the facility and Chairs or Co-Chairs the Facility Integrity and Compliance Committee meetings. Participates in the VISN Integrity and Compliance Committee meetings in order to share best practices with other VISN facilities. Interacts with the facility management, government agencies/contractors, Regional Counsel, and employees to ensure an understanding of the organization's initiatives toward compliance and to ensure consistency of compliance among the various divisions and service areas. Oversees the education and training process for the facility's employees regarding compliance related activities. Monitors questions, issues and reports of possible non-compliance reported through established mechanisms. Coordinates internal and external compliance reviews. Initiates investigation, when appropriate, of any issues of non-compliance as well as the implementation of appropriate corrective action plans. Provides the VISN 12 ICO with copies of the Integrity and Committee meeting minutes and informs him/her of any compliance issues. Periodically revises the program considering changes in the organization's needs, and in the law and policies and procedures of Government and private payer health plans. Coordinates personnel issues with Human Resources to ensure that providers and employees do not appear in the Cumulative Sanction Report; List of Excluded Individuals and Entities (LEIE reports). Provides support on medical record/billing documentation issues and assists in the development of guidelines for data compatibility and consistency, and monitoring for compliance to improve quality of clinical financial and administrative data. Reviews results of all internal audit reports and works closely with key managers to identify aberrant trends in the coding and billing areas. Collaborate with executive leadership and risk owners to prevent, detect, and manage potential FWA risks and provide oversight of the training, education, communication, tracking, and reporting of these types of activities. At the GS 12 level incumbent will assist with the supervision of Integrity and Compliance Auditors until advancement to full performance level of Health System Specialist, GS-671-13 is met. Promotion Potential: The full performance level of this vacancy is GS-13. The actual grade at which an applicant may be selected for this vacancy is GS-12 to GS-13.The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level. Work Schedule: Monday - Friday 7:30 am - 4:00 pm Compressed/Flexible: Not Authorized Telework: Ad-hoc; as determined by the agency Virtual: This is not a virtual position. Position Description/PD#: Health System Specialist (Facility Integrity & Compliance Officer)/PD252040