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This position is located in the Executive Director Department of the JJP VA Medical Center in the Bronx, NY. The Health System Specialist serves as the Integrity Compliance Specialist/Analyst for the OIC under the ICO who reports to the Director. The position serves as the principle advisor to the ICO and independently provides facility-wide analysis/reviews of revenue cycle and community care data as well as other facility-wide risk reviews/analysis.
03/14/2025 to 03/24/2025
$87,133 - $113,268 per year
GS 11
1 vacancy in the following location:
No
No
Not required
No
Permanent
Full-time
Competitive
None
No
No
CAZX-12709406-25-AS
833644300
ALL US CITIZENS DIRECT HIRE AUTHORITY: This position is being filled using Direct-Hire Authority (5 CFR 337.201) for this occupation.
MAJOR DUTIES AND RESPONSIBILITIES:
Office of Integrity and Compliance Program Management: The Health System Specialist functioning as Compliance Specialist/Analyst is responsible for completing programmatic auditing of facility-wide revenue process and community care oversight. Participates in systematic reviews of services. Assists in developing, implementing, or coordinating the implementation of corrective actions resulting from such reviews. The position ensures that all policies, procedures, and VHA Directive and guidance are being implemented. The incumbent processes the reviews through the entire flow of reimbursement and billing to include the following: auditing, performing route cause analysis, identifying areas of improvement, making recommendations of corrective actions, trending data, and then follow up with key business process owners of the operations.
Assist the ICO with the facility education and training plan for the facility's employees regarding compliance related activities i.e. new employee orientation (NEO), annual refresher compliance awareness training to all hospital employees, other groups as needed. Develops and/or provides effective education and training programs for all affective employees to mitigate identified risks. Develop reporting procedures, and measurements at various points in the training and education process to identify problem areas or needs of improvement, procedures, training and education information, and content.Conducts audits and/or other evaluation techniques to monitor compliance and to assist in the reduction of identified problem areas. Audits may be recurring and/or non-recurring in nature and originate from VHA, VISN, and facility risk activities.
Assist in development of a facility auditing and monitoring plan based on the facility risk assessment and various metric results. Monitoring due dates and retrieving and disseminating data to be reviewed using statistical sampling methodology. Analyze audit results, writes reports and recommends system changes to the ICO, as appropriate. Provides ICO with written reports of the findings of the audits conducted and works with the key business process owners to complete a Causation, Corrective Action Plan (CCAP) as needed.
Development of Programs, Policies, and Procedures: Develops programs to ensure that compliance program provisions are planned, developed and implemented to identify, prevent and correct unsatisfactory conditions and elements which influence the regulatory correctness and responsiveness of business and services. Develops databases and spreadsheets for tracking and trending results of analyses. Identifies indicators, progress measures, objectives and emphasis areas that are potentially non-compliant according to the VHA rules and regulations. Studies and Special Projects - Internal.
Controls and Oversight: Percent Designs studies, training programs and organizational strategies for identifying opportunities to improve performance and ensure adequate internal controls are in-place. Analyzes key steps in transaction process or business practice to identify potential material weaknesses. On a periodic basis assists the Integrity Compliance Officer in performing local health care system-wide reviews of internal controls effectiveness. Assists managers and staff to develop and implement internal control measures and monitors if there is a high risk of operational failure.
Development of Criteria: Develops reporting procedures, sampling techniques, and measurements at various points of the revenue program or business cycle to identify problem areas or inherent weaknesses in work processes, procedures, information systems and content. Develops indicators and monitors to provide objective evidence of the effectiveness of quality procedures and controls. Performs in depth analysis of stable work processes or service delivery practices to identify reasonable and efficient quality measurements tailored to the activity. Monitors quality program implementation and indicators designed to prevent erroneous transactions and ineffective work practices and to verify adherence to quality plans and requirements.
Program Implementation: Investigates and analyzes adverse quality trends or conditions and recommends corrective action. Consults with technical experts to examine and analyze unusual or problem situations indicated by changes in program quality indicators. Performs in-depth research, analyzes operating contingencies and special situations. Assists managers and staff in developing process solutions.
Perform other duties as assigned, normally of a related nature.
Work Schedule: Monday to Friday 8am to 4:30pm
Telework: This is not a telework position.
Virtual: This is not a virtual position.
Position Description Title/PD#: Health System Specialist PD555340
You must have at least one (1) full year of specialized experience equivalent to at least the next lower grade level (GS-9) in the Federal Service, that is directly related to the work of the position and has equipped you with the particular knowledge, skills and abilities to successfully perform the duties as a Health System Specialist ((Integrity Compliance Specialist/Analyst). Qualifying specialized experience is defined as 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:
(1) Missions, organizations, programs, and requirements of health care delivery systems;
(2) Regulations and standards of various regulatory and credentialing groups; and
(3) Government -wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement.
OR,
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.
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 VA competitive service employees with selection priority over other candidates for competitive service vacancies. To be well-qualified, applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors if applicable, and must be proficient in most of the requirements of the job. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website which can be found at https://www.opm.gov/.
This job opportunity announcement may be used to fill additional vacancies.
If you are unable to apply online and request information about the Alternate Application process, please contact the Agency Contact listed for this Job Opportunity Announcement (JOA).
You will be evaluated for this job based on how well you meet the qualifications above.
IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Applicants will be referred in the order in which they were received.
Documents Accepted:
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.
All applicants are encouraged to apply online.
To apply for this position, you must complete the occupational questionnaire and submit the documentation specified in the Required Documents section. The complete application package must be submitted by 11:59 PM (EST) on 03/24/2025 to receive consideration. To preview the questionnaire click https://apply.usastaffing.gov/ViewQuestionnaire/12709406.
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This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/job/833644300. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.
