This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/job/821679900. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.
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Summary
This position is located in the Purchased Referred Care Department at the Nashville Area Indian Health Service. The purpose of the position is to administer the provision of Purchase/Referred Care (PRC) in compliance with regulatory requirements to determine patient's eligibility for third party resources. This position is Remote and located under the Nashville Area Office, Nashville, TN.
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Overview
- Accepting applications
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Open & closing dates
12/02/2024 to 12/20/2024
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Salary
$44,117 - $70,578 per year
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Pay scale & grade
GS 6 - 8
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Location
4 vacancies in the following location:
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Anywhere in the U.S. (remote job)
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Remote job
Yes
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Telework eligible
Not applicable, this is a remote position.
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Travel Required
Occasional travel - You may be expected to travel for this position.
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Relocation expenses reimbursed
No
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Appointment type
Term - 2 years
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Work schedule
Full-time
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Service
Competitive
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Promotion potential
8
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Job family (Series)
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Supervisory status
No
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Security clearance
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Drug test
No
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Position sensitivity and risk
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Trust determination process
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Financial disclosure
No
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Bargaining unit status
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Announcement number
IHS-25-NA-12623828-DE
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Control number
821679900
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This job is open to
Clarification from the agency
The IHS is required by law to give absolute preference to qualified applicants who meet the Secretary of the Interior's definition of Indian for appointment to vacancies within the IHS in accordance with established IHS policy as outlined in the Indian Health Manual Part 7, Chapter 3. The IHS is an Equal Opportunity Employer.
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Duties
- Receives, enters, and edits all non-IHS and IHS referrals.
- Verifies and determines patient's eligibility for third party resources.
- Performs research related to medical documentation, administrative compliance, and inquiries.
- Conducts virtual interviews or by telephone to gather pertinent information related to patient care.
- Ensures PRC funds are available prior to issuance of obligating documents on behalf of the government.
- Initiates medical authorizations.
- Gathers all necessary information for appeals or denials.
- Prepares periodic and special reports.
- Perform other duties as assigned.
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Requirements
Conditions of Employment
Selectee may be subject to a probationary/trial period
U.S. Citizenship is required
Selective Service Registration is required for males born after 12/31/1959
This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children. Due to this requirement, the agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes.
Measles and Rubella immunization required for selectees born after 1957 and seasonal influenza immunization is required for all staff working in Indian Health Service health care facilities.
Successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit www.dhs.gov/E-Verify/.
You will need to set up direct deposit so we can pay you.
Background Investigation: If you are selected for this vacancy, you must undergo a pre-employment fingerprint check and background investigation. Fingerprint results and background investigation documentation must be cleared prior to hire. After you begin your employment, your continued employment is contingent upon the outcome of a complete background investigation as determined by the sensitivity level of your position. The investigation must find that you are suitable for Federal employment in your position. If you are found not suitable, you will be terminated after you begin work. If you make a false statement in any part of your application, you may not be hired; you may be fired after you begin work; or subject to possible criminal charges. You may be subject to a credit check as a part of the background investigation process.
Qualifications
To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying.
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; religious; spiritual; community; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week.
MINIMUM QUALIFICATIONS:
GS-06 grade level: One (1) year of specialized experience equivalent to the GS-05 grade level.
GS-07 grade level: One (1) year of specialized experience equivalent to the GS-06 grade level.
GS-08 grade level: One (1) year of specialized experience equivalent to the GS-07 grade level.
Specialized Experience:
Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Please see grade level specialized experience examples below.
Specialized experience at the GS-06 Level:
One (1) year of specialized experience that equipped me with the particular knowledge, skills and abilities to successfully perform the duties of this position. This experience is related to the work of the position and equivalent to at least the GS-05 level in the Federal service as described in the vacancy announcement. Examples include: Working with a health care delivery system or similar system to respond to inquiries from individuals as they relate to the type of health services the medical facility can provide and to solve problems or educate individuals about medical facility health programs and procedures including tasks such as assisting patients in applications for entitlement for health related programs, interviewing patients and or a family member to obtain pertinent and accurate information, research current information involving changes in rules and regulations for alternate resources and determines the eligibility of patients seeking healthcare.
Specialized experience at the GS-07 Level:
One (1) year of specialized experience that equipped me with the particular knowledge, skills and abilities to successfully perform the duties of this position. This experience is related to the work of the position and equivalent to at least the GS-06 level in the Federal service as described in the vacancy announcement. Examples include: Work experience that demonstrates knowledge of eligibility requirements for health care benefit programs such as Medicare, Medicaid, Social Security Insurance, and other similar resources to help patients in applying for alternate resources if not directly eligible for health services the medical facility can provide including experience in interviewing clients for information and advising customers on various health care benefits and eligibility based on current health care laws, regulations, policies and procedures.
Specialized experience at the GS-08 Level:
One (1) year of specialized experience that equipped me with the particular knowledge, skills and abilities to successfully perform the duties of this position. This experience is related to the work of the position and equivalent to at least the GS-07 level in the Federal service as described in the vacancy announcement. Examples include: work experience that demonstrates comprehensive knowledge of rights and benefits of multiple alternate resources; advise patients of nonpayment or approval of claim; compile and write reports; contact alternate resources to explore reasons for adverse decision, the possibility of reconsideration, whether there are grounds for appeal; complete contacts independently including review of complex records, reconstruction of involved transactions, analysis of precedent decisions.
You must meet all qualification requirements within 30 days of the closing date of the announcement.
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; religious; spiritual; community; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week.
MINIMUM QUALIFICATIONS:
GS-06 grade level: One (1) year of specialized experience equivalent to the GS-05 grade level.
GS-07 grade level: One (1) year of specialized experience equivalent to the GS-06 grade level.
GS-08 grade level: One (1) year of specialized experience equivalent to the GS-07 grade level.
Specialized Experience:
Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Please see grade level specialized experience examples below.
Specialized experience at the GS-06 Level:
One (1) year of specialized experience that equipped me with the particular knowledge, skills and abilities to successfully perform the duties of this position. This experience is related to the work of the position and equivalent to at least the GS-05 level in the Federal service as described in the vacancy announcement. Examples include: Working with a health care delivery system or similar system to respond to inquiries from individuals as they relate to the type of health services the medical facility can provide and to solve problems or educate individuals about medical facility health programs and procedures including tasks such as assisting patients in applications for entitlement for health related programs, interviewing patients and or a family member to obtain pertinent and accurate information, research current information involving changes in rules and regulations for alternate resources and determines the eligibility of patients seeking healthcare.
Specialized experience at the GS-07 Level:
One (1) year of specialized experience that equipped me with the particular knowledge, skills and abilities to successfully perform the duties of this position. This experience is related to the work of the position and equivalent to at least the GS-06 level in the Federal service as described in the vacancy announcement. Examples include: Work experience that demonstrates knowledge of eligibility requirements for health care benefit programs such as Medicare, Medicaid, Social Security Insurance, and other similar resources to help patients in applying for alternate resources if not directly eligible for health services the medical facility can provide including experience in interviewing clients for information and advising customers on various health care benefits and eligibility based on current health care laws, regulations, policies and procedures.
Specialized experience at the GS-08 Level:
One (1) year of specialized experience that equipped me with the particular knowledge, skills and abilities to successfully perform the duties of this position. This experience is related to the work of the position and equivalent to at least the GS-07 level in the Federal service as described in the vacancy announcement. Examples include: work experience that demonstrates comprehensive knowledge of rights and benefits of multiple alternate resources; advise patients of nonpayment or approval of claim; compile and write reports; contact alternate resources to explore reasons for adverse decision, the possibility of reconsideration, whether there are grounds for appeal; complete contacts independently including review of complex records, reconstruction of involved transactions, analysis of precedent decisions.
You must meet all qualification requirements within 30 days of the closing date of the announcement.
Education
There are no education requirements.
Additional information
Per IHS policy (SGM 21-04) IHS selectees to positions located in Federally operated hospitals, health centers, and clinics must be fully vaccinated for COVID-19 before entry on duty or have IHS approve a medical or religious exemption. If an exemption is approved then wearing a face mask and regular testing for COVID-19 will be required. Your Human Resources Specialist will provide a list of documents acceptable as vaccination proof and instructions on how to submit your vaccination documentation or how to request a medical or religious exemption, if needed.
This position is eligible for workplace flexibilities which may include remote work or telework options, and/or flexible work scheduling. These flexibilities may be requested in accordance with the HHS Workplace Flexibilities policy. https://www.hhs.gov/about/agencies/asa/ohr/hr-library/990-1/index.html.
Additional selection(s) of candidates may be possible within 240 days from the date the certificate of eligibles was issued for this announcement.
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. IHS may offer newly-appointed Federal employees credit for their directly related previous 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.
This position is covered by a Bargaining Unit.
This position has promotion potential to the GS-08 grade level. Promotion to the next grade level is at management's discretion and is based on your demonstrated ability to perform the higher level duties, the continuing need for the higher level duties, and "Regulatory/Administrative" approval. Promotion to the next higher grade level is not guaranteed and no promise of promotion is implied.
Benefits
A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.
How You Will Be Evaluated
You will be evaluated for this job based on how well you meet the qualifications above.
If you meet the minimum qualifications requirements for this position, your application will be evaluated and rated under Category Rating selection procedures. Once the application process is complete, a review of your qualifications will be conducted to determine if you are qualified for this job. Qualified candidates will be assigned to a quality category. The quality categories are: Best Qualified, Well Qualified, or Qualified. Within each of these categories, applicants eligible for veteran's preference will receive selection priority over non-preference eligibles.
Please note that if, after reviewing your resume and or supporting documentation, a determination is made that you have inflated your qualifications and or experience, your category rating can and will be adjusted to more accurately reflect your abilities, or you may lose consideration for this position. Please follow all instructions carefully. Errors or omissions may affect your eligibility.
To determine if you are qualified for this position, a review of your resume and supporting documentation will be made and compared against the qualifications as defined in the qualifications section of this vacancy announcement and your responses to the assessment questions. You will be rated based on the information provided in your resume (your resume must state specific duties that relate to this position) and your responses to the assessment questions will be evaluated against the duties you provided in your resume, along with your submitted documentation to determine your ability to demonstrate the following.
- Customer Service (Clerical/Technical)
- Oral Communication
- Reasoning
- Technical Competence
The following links below provide information on how you may be eligible for various hiring authorities. If you are a Veteran, qualified CTAP and ICTAP eligible, or an individual with a disability, please refer to the following links below for additional guidance. CTAP and ICTAP candidates will be eligible for selection priority if it is determined that they have exceeded the minimum qualifications for the position by attaining at least a "well qualified" rating of 85 out of 100. Information about CTAP and ICTAP eligibility is on the Office of Personnel Management's Workforce Restructuring Career Transition website at: https://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/. CTAP/ICTAP documentation requirements are listed in the "Required Documents" section of this announcement.
- Veterans, i.e. (VEOA, VRA, and 30% or more disabled) - https://www.opm.gov/policy-data-oversight/veterans-services/vet-guide-for-hr-professionals/
- Career Transition Assistance Program (CTAP) - http://www.ihs.gov/jobs/support-documents/
- Interagency Transition Assistance Program (ICTAP) - https://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/
- Schedule A Appointments for the Disabled - https://www.opm.gov/policy-data-oversight/disability-employment/hiring/
Click here to view vacancy questions: https://apply.usastaffing.gov/ViewQuestionnaire/12623828. All documents above MUST be received by 11:59 pm (Eastern Standard Time) of the closing date of, 12/20/2024, to be considered.
Benefits
A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.
Required Documents
As a new or existing federal employee, you and your family may have access to a range of benefits. Your benefits depend on the type of position you have - whether you're a permanent, part-time, temporary or an intermittent employee. You may be eligible for the following benefits, however, check with your agency to make sure you're eligible under their policies.
Resume: You are highly encouraged to use USAJOBS Resume Builder to ensure all required information is included in your Resume. If you use your own resume, curriculum vitae, or any other written form you choose then you must describe your job-related qualifications that includes beginning and ending dates for paid and non-paid work experience, hours worked per week, month and year of employment for each job title listed, annual salary, and description of job duties. Include name and address of employer; supervisor name and telephone number.
Required as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements:
Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only." Indian preference will not be given unless a properly signed and dated form is submitted with your application, including any verification by an authorized Tribal Representative or BIA Official of tribal enrollment records. For detailed instructions, see form BIA-4432. Refer to BIA-4432 link: https://www.bia.gov/sites/default/files/dup/assets/public/raca/online_forms/pdf/1076-0160_INDIAN-PREF_Expires-10.31.24_508.pdf. When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference.
Veterans Preference: If claiming Veteran's Preference provide a copy of your DD214 Form (Member 4 copy). To claim 10-Point Veterans Preference, submit a SF-15 Application (http://www.opm.gov/forms/pdf_fill/SF15.pdf) along with the appropriate supporting documentation. For additional information regarding Veterans Preference visit: http://www.fedshirevets.gov.
Career Transition Assistance Program (CTAP)/Interagency Career Transition Assistance Program (ICTAP): If you are claiming CTAP/ICTAP, follow the instructions below: http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/ctap_guideline.pdf.
You must meet the requirements of the job by 11:59 (Eastern Standard Time) of the closing date: 12/20/2024
If you are relying on your education to meet qualification requirements:
Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education.
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
How to Apply
To apply for this position, you must provide a complete Application Package. See required documents below.
- Click 'Apply' to create an account or log in to your existing USAJOBS account.
- Follow the prompts to upload your resume and/or supporting documents.
- Read all Eligibility questions and respond accordingly. .
- Complete the assessment questions.
- Verify all required documentation is included in your application package
Agency contact information
Pamela Harrison
- Address
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Nashville Area Indian Health Service
711 Stewarts Ferry Pike
Nashville, TN 37214-2634
US
Next steps
You can track the progress of your application package via your USAJobs account. You will receive an acknowledgement from USAJobs that your submission was successful once we have received your on-line occupational questionnaire, resume, and any supporting documentation. You will be notified of the status of your application via your USAJobs Account after we conduct a qualification review of your complete application package. You will be contacted if further evaluation or interviews are required. Any exaggeration of your experience, false statements, or attempt to conceal information may disqualify you for employment consideration. We may verify all information you provide in your resume and questionnaire responses, through reference and/or background check, and/or verification of your education. If you are selected, you will be contacted personally by the human resources office posting this announcement.
If all required documentation is not submitted with your application you will lose consideration. It is the applicant's responsibility to verify that information and documents entered, uploaded, or faxed are received, legible and accurate. HR will not modify answers submitted by an applicant.
HHS has a critical preparedness and response mission: HHS protects the American people from health threats, researches emerging diseases, and mobilizes public health programs with domestic and international partners. In support of this mission, HHS offers its employees the opportunity to volunteer to become Federal Civilian Detailees and contribute their unique skills through voluntary temporary assignments to humanitarian emergencies or Departmental priorities countering new and emerging health, safety, and security threats.
~ ~ ~ Indian Health Service is an Equal Opportunity Employer ~ ~ ~
Fair and Transparent
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
Help
Required Documents
Resume: You are highly encouraged to use USAJOBS Resume Builder to ensure all required information is included in your Resume. If you use your own resume, curriculum vitae, or any other written form you choose then you must describe your job-related qualifications that includes beginning and ending dates for paid and non-paid work experience, hours worked per week, month and year of employment for each job title listed, annual salary, and description of job duties. Include name and address of employer; supervisor name and telephone number.
Required as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements:
Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only." Indian preference will not be given unless a properly signed and dated form is submitted with your application, including any verification by an authorized Tribal Representative or BIA Official of tribal enrollment records. For detailed instructions, see form BIA-4432. Refer to BIA-4432 link: https://www.bia.gov/sites/default/files/dup/assets/public/raca/online_forms/pdf/1076-0160_INDIAN-PREF_Expires-10.31.24_508.pdf. When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference.
Veterans Preference: If claiming Veteran's Preference provide a copy of your DD214 Form (Member 4 copy). To claim 10-Point Veterans Preference, submit a SF-15 Application (http://www.opm.gov/forms/pdf_fill/SF15.pdf) along with the appropriate supporting documentation. For additional information regarding Veterans Preference visit: http://www.fedshirevets.gov.
Career Transition Assistance Program (CTAP)/Interagency Career Transition Assistance Program (ICTAP): If you are claiming CTAP/ICTAP, follow the instructions below: http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/ctap_guideline.pdf.
You must meet the requirements of the job by 11:59 (Eastern Standard Time) of the closing date: 12/20/2024
If you are relying on your education to meet qualification requirements:
Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education.
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
Help
Learn more about this agency
How to Apply
To apply for this position, you must provide a complete Application Package. See required documents below.
- Click 'Apply' to create an account or log in to your existing USAJOBS account.
- Follow the prompts to upload your resume and/or supporting documents.
- Read all Eligibility questions and respond accordingly. .
- Complete the assessment questions.
- Verify all required documentation is included in your application package
Agency contact information
Pamela Harrison
- Address
-
Nashville Area Indian Health Service
711 Stewarts Ferry Pike
Nashville, TN 37214-2634
US
Next steps
You can track the progress of your application package via your USAJobs account. You will receive an acknowledgement from USAJobs that your submission was successful once we have received your on-line occupational questionnaire, resume, and any supporting documentation. You will be notified of the status of your application via your USAJobs Account after we conduct a qualification review of your complete application package. You will be contacted if further evaluation or interviews are required. Any exaggeration of your experience, false statements, or attempt to conceal information may disqualify you for employment consideration. We may verify all information you provide in your resume and questionnaire responses, through reference and/or background check, and/or verification of your education. If you are selected, you will be contacted personally by the human resources office posting this announcement.
If all required documentation is not submitted with your application you will lose consideration. It is the applicant's responsibility to verify that information and documents entered, uploaded, or faxed are received, legible and accurate. HR will not modify answers submitted by an applicant.
HHS has a critical preparedness and response mission: HHS protects the American people from health threats, researches emerging diseases, and mobilizes public health programs with domestic and international partners. In support of this mission, HHS offers its employees the opportunity to volunteer to become Federal Civilian Detailees and contribute their unique skills through voluntary temporary assignments to humanitarian emergencies or Departmental priorities countering new and emerging health, safety, and security threats.
~ ~ ~ Indian Health Service is an Equal Opportunity Employer ~ ~ ~
Fair & Transparent
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
Beginning of a dialog window for the agency announcing this job. It begins with a heading 2 called "Learn more about Field Operating Offices of the Office of the Secretary of the Army". Escape will cancel and close the window.
Learn more about
Indian Health Service
Become a part of an innovative, dynamic, nationwide organization of dedicated health care providers working to meet the individual health care needs of American Indians and Alaska Natives. Indian Health Service (IHS) employees are considerate in our care, creative in our approach, enthusiastic about our work and compassionate with our patients. Our lifestyle is adventurous, community oriented and focused on service and problem solving as part of a professional interdisciplinary team. Join us in improving the health outcomes of over 2 million American Indians and Alaska Natives.
Agency contact information
Pamela Harrison
- Address
-
Nashville Area Indian Health Service
711 Stewarts Ferry Pike
Nashville, TN 37214-2634
US