Health System Specialist - Credentialing

Summary

This position serves as a subject-matter authority on provider network management support functions, including provider credentialing, quality of care provided under the auspices of Program Office Care program operations and initiatives, and training. Applicant Count: This job announcement will automatically close at 11:59pm EST on the date the applicant count of 100 applications has been reached or on the closing date, whichever comes first.

Duties

THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION Duties may include, but are not limited to the following: Serves as the subject matter expert on healthcare provider credentialing and facility accreditation, evaluating the quality, accuracy, and compliance of credentialing and accreditation activities performed by contracted organizations. Reviews and analyzes credentialing, accreditation, and provider qualification data to identify trends, risks, compliance concerns, and opportunities for improvement, and communicates findings to leadership. Develops and conducts audits, reviews, and performance assessments of contractor-managed credentialing and accreditation processes to ensure providers and healthcare facilities meet required standards, contractual requirements, and industry best practices. Evaluates the effectiveness of credentialing, recredentialing, primary source verification, accreditation, and related quality assurance processes conducted by contracted credentialing and verification organizations. Monitors contractor performance to ensure healthcare providers and facilities are credentialed, verified, and accredited in accordance with applicable standards, policies, regulations, and contract requirements. Provides expert guidance to leadership on healthcare credentialing, accreditation, provider qualifications, regulatory requirements, industry standards, and emerging trends affecting healthcare quality and patient safety. Collaborates with contractors, healthcare organizations, accrediting bodies, and internal stakeholders to address audit findings, compliance concerns, corrective action plans, and quality improvement initiatives related to credentialing and accreditation programs. Represents the organization in meetings, workgroups, and professional forums involving healthcare credentialing, accreditation, provider quality, and compliance matters. Performs other related duties as assigned. Work Schedule: Monday-Friday, 8:00am-4:30pm Recruitment & Relocation Incentives: Not authorized Critical Skills Incentive (CSI): Not Approved Telework: This position may be authorized for telework. Telework eligibility will be discussed during the interview process. Requirements

You must be a U.S. Citizen to apply for this job To be considered for this position, you must complete all required steps in the process. In addition to the application and questionnaire, this position requires an online assessment. The online assessment measures critical general competencies required to perform the 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 Physical Requirements: Work is typically sedentary, occasionally requiring some standing, walking and stooping. A pre-placement physical examination is not required. 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) - See "Required Documents" below for details. As a condition of employment for accepting this position, you will be required to serve a 1-year probationary 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, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest. Qualifications

This position includes a Selective Placement Factor (skill, knowledge, ability or other worker characteristic basic to - and essential for - satisfactory performance of the job). Selective Placement Factors are a prerequisite to appointment and represent minimum requirements for a position. Applicants who do not meet it are ineligible for further consideration. The Selective Placement Factor for this position is: "Possess experience developing and evaluating programs specifically related to healthcare provider credentialing and facility accreditation." AND In addition to meeting the Selective Placement Factor, to qualify for this position at the GS-12 grade level, you must meet the following: SPECIALIZED EXPEREINCE: Have at least one (1) year of specialized experience directly related to this position. To be creditable, this experience and education must have been equivalent to at least the next lower grade level (GS-11) in the Federal Service that is directly related to the position. Specialized experience includes: 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: (a) Missions, organizations, programs, and requirements of health care delivery systems; (b) Regulations and standards of various regulatory and credentialing groups; (c) Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel and procurement; establishing management and leadership practices across the facility that embrace inclusion, innovation, data-drive and patient centered concepts. 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. 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

There is no educational substitution at this grade level. 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 (knowledge, skills, abilities, and other characteristics): Attention to Detail Customer Service Decision Making Flexibility Integrity/Honesty Interpersonal Skills Learning 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. Candidates who apply under "All U.S. Citizens" announcements will be rated and ranked using Category Rating procedures. Qualified candidates will be assigned to a quality category. The categories are defined as follows: Best qualified - Applicants possessing the type and quality of experience that substantially exceeds the minimum qualifications Very Highly Qualified - Applicants possessing the type and quality of experience that exceeds, to a very considerable extent, the minimum qualifications Highly Qualified - Applicants possessing the type and quality of experience that exceeds, to a considerable extent, the minimum qualifications Well qualified - Applicants possessing the type and quality of experience that marginally exceeds the minimum qualifications of the position and who demonstrate average proficiency in most of the critical competencies Qualified - Applicants possessing the type and quality of experience that meets the minimum qualifications Application of Veterans' Preference: Category rating and selection procedures place those with veteran's preference above non-preference eligibles within each category. Preference eligible applicants that meet the eligibility and qualification requirements and who have a compensable service-connected disability of at least 10 percent are listed in the highest quality category (except when the position being filled is scientific or professional at the GS-09 grade level or higher). 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. Other Information

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. Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience. 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. 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. The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced Federal competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation and be found well-qualified (have a final rating of 80 or more before any Veterans preference points) for this vacancy. 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/.