Program Specialist

Summary

The Northern Arizona VA Health Care System is currently recruiting for one Program Specialist in the Community Care Service, Prescott, Arizona. The incumbent conducts reviews in the areas of community care coordination and payment of claims related to care in the community with the Budget Analyst to attempt and resolve concerns from Veterans and community providers

Duties

The incumbent conducts reviews as required by their direct supervisor and medical center leadership. Other duties include, but are not limited to, the following: Contact members of the hospital staff at all levels concerning patient care issues not been resolved by other services and seeks resolution utilizing the full resources of the medical center and VA system. Explore all avenues, crossing lines of authority and responsibility within the medical center, to identify the nature and scope of the problem and to initiate appropriate action for resolution. Independently resolves the most difficult, complex, and sensitive care issues and system-related problems, applying advanced judgement across multiple program areas and organizational levels. Gather, analyze, and prepares information using sound judgement in response to inquiries, including Congressional Offices, White House Hotlines, Advance Credit Reports (ACR), VAIQs, Exec VA, CBI Helpline, Call Center Portals, and Reports of Contact while managing relationships across business units. Reviews files and records, and discusses with personnel or witnesses regarding any practice that appears to violate patient's rights or which causes unnecessary discomfort or embarrassment to patients, their families, or the health care facility and reports such findings with recommendations for improvements to the facility Director and/or top management team. Ensure national VA patient advocacy program requirements are met by collecting, analyzing, and evaluating relevant data, and preparing meaningful reports based on that data. - Evaluates the effectiveness, efficiency, and compliance of Community Care operations and related processes, and develops data-driven recommendations for improvement. Applies analytical and evaluative methods to assess program performance, identify trends, and recommend enhancements to improve service delivery and patient outcomes. Serve as an advocate for patients throughout Community Care Service, receiving and addressing complaints and grievances from patients or their representatives. Provides explanation regarding Veteran eligibility/entitlement to benefits according to the Veterans' Benefit Package and the laws and regulations governing VA authority to authorize payment for care in the community. Communicate with the Veteran to assist in filing claims and explain what action is needed by the Veteran to support their claims. Receives telephone calls regarding denied or rejected claims and coordinates with appropriate personnel when additional information is required for further review. Provides consultative guidance to leadership, staff, and stakeholders regarding patient advocacy issues, program operations, and regulatory requirements. Interprets and applies Federal laws, VA regulations, policies, and procedures to ensure compliance with the Mission Act and other governing authorities. Coordinates and reroutes calls appropriately with multiples departments are involved. Facilitates and follows through to ensure final resolution to the customer. Performs all other duties as assigned. Promotion Potential: 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 through Friday, 8:00am to 4:30pm (Tour may be subject to change based on needs of the facility). Telework: Not Authorized Virtual: This is not a virtual position. Compressed/Flexible: Not Authorized Position Description/PD#: Program Specialist/PD132990 Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required 30 Day Hiring Model The Department of Veterans Affairs is implementing a streamlined 30-Day Hiring Model designed to accelerate hiring while maintaining the highest standards of merit-based selection. This improved process reduces traditional hiring timelines by integrating early coordination, faster assessments, and efficient pre-employment actions. Applicants can expect a more transparent, predictable, and efficient hiring journey from announcement to entry on duty. What Applicants Can Expect: Expedited Candidate Review Once the announcement closes, Human Resources will quickly review applications, issue certificates of eligible candidates the day after the announcement closes and refer applicants for hiring manager consideration. Requirements

You must be a U.S. Citizen to apply for this job All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. Selective Service Registration is required for males born after 12/31/1959 Subject to background/security investigation Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period or 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider: your performance and conduct; the needs and interests of the agency; whether your continued employment would advance organizational goals of the agency or the Government; and whether your continued employment would advance the efficiency of the Federal service. Upon completion of your probationary period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest. Qualifications

30 Day Hiring Model Cont... What Applicants Can Expect: Expedited Candidate Review Once the announcement closes, Human Resources will quickly review applications, issue certificates of eligible candidates the day after the announcement closes and refer applicants for hiring manager consideration. Quick Interviews & References HR may arrange interviews and will request references within 3-5 days after being referred to the hiring manager. Streamlined Pre-Employment Requirements: Following a tentative offer, applicants should be prepared to complete required steps, such as fingerprinting and background check, credentialing, and medical examination within 3 days of the offer. Clear and Timely Communication: Applicants will receive clear communication at key milestones, including referral, tentative offer, and onboarding instructions. To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 08/31/2026. 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-09 position you must have served 52 weeks at the GS-07. For a GS-11 position you must have served 52 weeks at the GS-09.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: You may qualify based on your experience and/or education as described below: GS-09: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-07 in the normal line of progression for the occupation in the organization. Qualifying specialized experience includes providing customer service to patients; assisting patients and staff with resolving problems or complaints; assisting with identifying problem areas and suggesting solutions or alternatives; explaining policies and procedures; keeping accurate records and preparing reports and/or written correspondence. 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: Successfully completed two (2) years of progressively higher-level graduate education or masters or equivalent graduate degree or LL.B. or J.D., in a related field of the position to be filled. Education at the graduate level must have been obtained in an accredited college or university and must demonstrate the knowledge, skills, and abilities necessary to do the work of this position. NOTE: 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 experience requirements. The education portion must include graduate courses that demonstrate the knowledge, skills, and abilities necessary to do to the work of this position. This education must have been obtained in an accredited college or university. NOTE: Transcripts must be submitted with your application materials. Education cannot be credited without documentation. Experience must be clearly indicated in your resume. GS-11: Specialized Experience: You must 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. Qualifying specialized experience includes providing customer service to patients and staff with resolving problems or complaints; identifying problem areas and suggesting solutions or alternatives; explaining policies and procedures; keeping accurate records and preparing reports and/or written correspondence; collaborating with facility staff to improve the patient experience. 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: Successfully completed three (3) years of progressively higher-level graduate education leading to a Ph.D. degree, or Ph.D., or equivalent doctoral degree in the related field of the position to be filled. The education portion must include courses that 4/30/2026 10:13 EDT Page 4 of 7 demonstrate the knowledge, skills, and abilities necessary to do the work of this position. Education must have been obtained in an accredited college, or university. NOTE: 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 2 years) and specialized experience as described above to meet total experience requirements. The education portion must include graduate courses that demonstrate the knowledge, skills, and abilities necessary to do to the work of this position. NOTE: Transcripts must be submitted with your application materials. Education cannot be credited without documentation. Experience must be clearly indicated in your resume. Preferred Experience : Experience and knowledge in Community Care programs, including systems used for consultation management such as RefDoc, HSRM, and EPS. 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/.

Education

A transcript must be submitted with your application if you are basing all or part of your qualifications on education. Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/. How You Will Be Evaluated

Your qualifications will be evaluated based on your application materials (e.g., resume, supporting documents), your responses on the application questionnaire, and your responses to all assessments required for this position. You will be assessed on the following Competencies for this position: Attention to Detail Customer Service Decision Making Flexibility Integrity/Honesty Interpersonal Skills Learning Reading Comprehension Reasoning Self-Management Stress Tolerance Teamwork Your 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. 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. IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Overstating your qualifications and/or experience in your application materials or application questionnaire may result in your removal from consideration. Cheating on the online assessment may also result in your removal from consideration. 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. During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions. Special Employment Consideration: VA encourages persons with disabilities to apply, including those eligible for hiring under 5 CFR 213.3102(u), Schedule A, Appointment of persons with disabilities [i.e., intellectual disabilities, severe physical disabilities, or psychiatric disabilities], and/or Disabled veterans with a compensable service-connected disability of 30% or more. Contact the Agency Contact for information on how to apply under this appointment authority via the Selective Placement Coordinator. Other Information

Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act. Reasonable Accommodation (RA) Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments if you received the link after the close of the announcement. To determine if you need a RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments. Receiving Service Credit for Earning Annual (Vacation) Leave: Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. VA may offer newly-appointed Federal employee's credit for their job-related non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed. This job opportunity announcement may be used to fill additional vacancies. The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced VA competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation (a copy of the agency notice, your most recent performance rating, and your most recent SF-50 noting current position, grade level, and duty location) and be found well-qualified for this vacancy. To be well-qualified: applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the required competencies of the job. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website at http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/.