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Program Specialist

Company: Department of Veterans Affairs
Location: Prescott
Posted on: May 3, 2021

Job Description:

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Summary

The Northern Arizona VA Health Care System is currently recruiting for one (1) Program Specialist (Customer Service Spec) to work in the Community Care Service, Prescott, Arizona. The incumbent is a Mission Act and Choice 40 Champion who 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.

Learn more about this agency

Responsibilities

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 any matter or problem relating to patient care which has not been resolved by other services and seeks a resolution, whenever possible, within the full resources of the medical center and VA system.
  • Explore all avenues, crossing all lines of authority and responsibility within the medical center, in order to properly identify the nature and scope of the problem and to initiate appropriate action to expedite a resolution.
  • Gather, analyze, and prepare information while applying sound judgement when responding to inquiries to include those from Congressional Offices, White House Hotlines, Advance Credit Reports (ACR), VAIQs, Exec VA, CBI Helpline, Call Center Portals, Reports of Contact, and others as assigned appropriately managing relations across business units.
  • Review 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 that national VA patient advocacy program requirements are met by collecting, analyzing, and evaluating relevant data; and preparing meaningful reports based on that data.
  • Serve as an advocate for patients throughout Community Care Service.
  • Receive and listen to complaints and grievances from patients or from individuals on behalf of patients.
  • Provide 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.
  • Receive telephone calls regarding denied/rejected claims for various reasons and notifies the voucher examiner or designated personnel when additional information necessitates a second review of the claim.
  • Coordinate and reroute calls appropriately in instances where other departments must be involved.
  • Facilitate and follow through to ensure final resolution to the customer.

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 - Friday 8:00am - 4:30pm

Telework: Not Available

Virtual: This is not a virtual position.

Position Description/PD#: Program Specialist/PD13298O

Relocation/Recruitment Incentives: Not Authorized

Financial Disclosure Report: Not required

Travel Required

Not required

Supervisory status

No

Promotion Potential

11

  • Job family (Series)

0301 Miscellaneous Administration And Program

  • Requirements

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Requirements

Conditions of Employment

  • You must be a U.S. Citizen to apply for this job
  • Designated and/or random drug testing may be required
  • Selective Service Registration is required for males born after 12/31/1959
  • You may be required to serve a probationary period
  • Subject to background/security investigation
  • Selected applicants will be required to complete an online onboarding process

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 05/14/2021.

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-9 position you must have served 52 weeks at the GS-7.

For a GS-11 position you must have served 52 weeks at the GS-9.

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:

GS-9 Grade Level - Specialized Experience: In addition to meeting time-in-grade requirements, you must have one year of specialized experience equivalent to at least the next lower grade (GS-7) in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Performing reviews by examining Veteran's medical records, community care authorizations, community payment records and historical tracking of submitted health care claims. OR,

Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a master's or equivalent graduate degree or 2 full years of progressively higher-level graduate education leading to such a degree or related LL.B. or J.D. . OR,

GS-11 Grade Level (Full-Performance Level) - Specialized Experience: In addition to meeting time-in-grade requirements, you must have one year of specialized experience equivalent to at least the next lower grade (GS-9) in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Performing reviews by examining Veteran's medical records, community care authorizations, community payment records and historical tracking of submitted health care claims. OR,

Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have successfully completed a Ph.D. or equivalent doctoral degree. OR Successfully completed three full years of progressively higher-level graduate education leading to a Ph.D. OR I have an equivalent degree, or LL.M degree . OR,

Combination: Applicants may also combine education and experience to qualify at this level. Only graduate education in excess of the amount required for the next lower grade level may be used to qualify applicants for positions at grades GS-9 and GS-11.. It may be computed by first determining the applicant's total qualifying experience as a percentage of the experience required for the grade level; then determining the applicant's education as a percentage of the education required for the grade level; and then adding the two percentages. The total percentages must equal at least 100 percent to qualify an applicant for that grade level.

You will be rated on the following Competencies for this position:

  • Analytical Reasoning
  • Communication
  • Manages and Organizes Information
  • Organizational Awareness

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: The work is primarily sedentary, although some slight physical effort may be required.

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: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.

Keywords: Department of Veterans Affairs, Prescott , Program Specialist, Other , Prescott, Arizona

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