The primary functions of the incumbent are to assist the Primary Care/Managed Care Product Line (PC/MC PL), in providing advisory and technical assistance to beneficiary patients seeking medical care, information or guidance from the contracted Community Based Outpatient Clinics (CBOC). The incumbent is assigned as a Program Assistant in the Primary Care Managed Care Product Line of the South Texas Veterans Health Care System (STVHCS).
To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 02/02/2026. 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-06 position you must have served 52 weeks at the GS-05. 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 as described below: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-05 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: obtains information from the various contracts as they relate to payment rates and prepares monthly enrollment listing for payment of services performed; reviews and analyzes bills received for payment to: (1) ensure charges are within negotiated contract; (2) eliminate any unnecessary or duplicate charges; (3) verify the patient was seen at the facility in question; (4) validate bills against actual patient information. Knowledge of billing inquiries for various contracts. Knowledge on maintaining up-to-date financial fund control point obligations. You will be rated on the following Competencies for this position: Customer Service Administration and Management Contracting/Procurement Physical Requirements: Work is mostly sedentary with some walking, bending, standing in completing various stages of the daily tasks and carrying of light objects such as supplies and documentation manuals and records. There will be some lifting and transferring of baskets or boxes of supplies and records more than 15 pounds. The incumbent must have adequate eyesight and hand dexterity to allow for reading and operating a computer keyboard. The incumbent is required to answer numerous personal/telephonic inquiries and must have adequate eyesight and hand dexterity to allow for reading and operating a computer. 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: Data Analysis: The PA is responsible for the accountability of over 23 million dollars for CBOC contract services. The incumbent obtains information from the various contracts as they relate to payment rates and prepares monthly enrollment listing for payment of services performed at each CBOC. She/He reviews and analyzes bills received for payment to: (1) ensure charges are within negotiated contract; (2) eliminate any unnecessary or duplicate charges; (3) verify the patient was seen at the facility in question; (4) validate bills against actual patient information. Incumbent is the point-of-contact for billing inquiries for the various CBOC contracts. Handles patients concerns and issues and working with the Program Specialist to ensure all the needs of the Veterans are met timely. Handles suspenses assigned timely and ensure all the needs of the contract needs are met. Incumbent is responsible for maintaining up-to-date financial fund control point obligations. This includes establishment of 1358's, 2237's, and decreasing and increasing obligations as necessary. She/He utilizes the Veteran's Health Administration (VHA) Financial Management System (FMS), Control Point Activity, Accounting and Procurement (IFCAP) to monitor both the obligated and unobligated balances. The PA assists the CBOC Program Specialist in projecting the need for additional funding requirements to senior management. Administrative Duties: The incumbent works closely with the CBOC Program Specialist. He/She assists CBOC Program specialist in orienting and advising the CBOC personnel regarding the VA regulations, policies and procedures on administrative matters, basic eligibility for benefits and status for evaluation into CBOC. Through constant surveillance, maintains contact with medical and administrative staff in various areas/services to resolve delays and misunderstandings in the medical administrative aspects of providing medical care. Work Schedule: Monday-Friday / 0800-1630 Virtual: This is not a virtual position. Position Description/PD#: Program Assistant/PD008270 Relocation/Recruitment Incentives: Not Authorized