This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/job/528071100. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.
This position is located in the Department of Labor (DOL), Office of Workers’ Compensation Programs (OWCP), Division of Administration and Operations (DAO), Branch of Medical Standards and Rehabilitation (BMSR) in Washington, DC.
Learn more about this agency03/20/2019 to 04/04/2019
$96,970 - $126,062 per year
GS 13
1 vacancy in the following location:
Yes—as determined by the agency policy.
Occasional travel - Occasional travel may be required for trainings.
No
Permanent
Full-Time
Competitive
13 - This position has no further promotion potential.
No
No
MS-19-PHIL-OWCP-0062
528071100
Current or former competitive service federal employees.
Federal employees who meet the definition of a "surplus" or "displaced" employee.
Certain current or former term or temporary federal employees of a land or base management agency.
Current/former Federal competitive status employees/reinstatement eligibles; ICTAP/CTAP eligibles in the local commuting area; Veteran Employment Opportunity Act (VEOA) eligibles; Land and Base Management Workforce Flexibility Act eligibles; and Military Spouses.
The mission of BMSR is to provide medical opinions and technical advice and assistance concerning medical claims; to establish medical standards for all OWCP programs; to work with contractors and OWCP programs to adapt medical policy to a Medical Bill Processing System; to monitor the system’s operation and the medical payments; and to ensure that such standards are medically and scientifically sound and consistent with OWCP policy.
This position is inside of the bargaining unit.
Additional selections may be made from this announcement.
Incumbent must be able to obtain the appropriate background/security investigation required for this position.
Relocation (PCS) expenses are not authorized.
MAJOR DUTIES INCLUDE THE FOLLOWING:
Conducts in-depth analysis and review of OWCP’s internal controls and related program requirements throughout all four benefit programs. Through the continual collection and analysis of applicable data and reports, the incumbent identifies risk and problem areas towards fraud detection; drafts research plans and conducts special analyses or studies of potential fraud cases; identifies current and emerging issues that are of significant interest to OWCP; and makes recommendations for effective solutions to mitigate internal control risks and areas of fraud by medical professionals or other medical facilities. Works closely with the senior program integrity analyst in developing new questions, templates, queries, and statistical parameters to support pattern recognition that indicates fraudulent activity.
Participates in the development of internal control policies and procedures for minimization of waste, fraud, and abuse and disseminates to stakeholders, as appropriate. Reviews reports on internal and external controls (e.g., SOC 1&2 / SSAE 18) and makes recommendations for the development of effective relevant controls that involve reconciling output reports or files; conducting periodic discussions; and developing new strategies and integrating action plans to measure accomplishments, results, and effectiveness of the programs.
Prepares and presents reports and other materials requested by the Office of Inspector General (OIG). Assists management with any OIG investigation of improper requests for payment and improper payments. Ensures compliance with internal control procedures as it relates to Improper Payments Elimination and Recovery Act (IPERA).
Conducts analysis of broad audit-related activities and ensures audit requirements and findings adhere to established guidelines. As necessary, the incumbent provides expert technical direction and guidance to audit teams on the medical bill sample collection process and other evaluation methods and techniques. Coordinates with appropriate DOL and OWCP personnel in acquiring and compiling responses to medical bill audit findings. Conducts in-depth review and analysis of the full-range of complex data submitted and/or obtained for the audits and makes recommendations to leadership regarding policy and process improvements that impact all four benefit programs.
Participates with the senior program integrity analyst in developing audit requirements for assigned critical audit area(s) and preparing written, in-depth reviews of OWCP programs and Branch assessment results and findings. Drafts periodic reports of analytical findings used by the senior program integrity analyst to brief Program Heads, DAO Director, and Deputy Director.
Plans and conducts both short- and long-term projects and studies that directly impact OWCP’s mission. Drafts new or revised performance measures to monitor and evaluate the Workers Compensation Medical Bill Processing (WCMBP) for technical accuracy, consistency, and efficiency.
Utilizing the Agency library and tracking system, the incumbent responds to various inquiries and recommendations from internal and external stakeholders, resolves issues that arise, and ensures systems comply with established policies and procedures.
Presents analytical findings, reports, and corrective actions surrounding program integrity, audits, and operational deficiencies to leadership. This information is utilized by leadership to make informed decisions regarding short- and long-term program planning. The incumbent answers queries related to program and policy issues in a timely manner and ensures answers are correct and complete. Sensitive issues will be dealt with professionalism, tact, and diplomacy at all times.
May serve as a BMSR representative in meetings with Treasury, GAO, KPMG (a professional service company and one of the largest accounting and auditing firms), and OIG senior contacts to discuss findings and resolve issues associated with program integrity and audit matters. May participate on taskforces and working groups concerned with potential fraud investigations and judicial processes relating to fraud prosecutions.
Performs other duties as assigned.
Applicants must meet time-in-grade, time-after-competitive-appointment and qualifications requirements within 30 calendar days after the closing date of the vacancy to be eligible for consideration for selection.
Federal Employees Please Note: Your SF-50 must include enough information to be able to determine that time-in-grade requirements have been met and reflects your position title, pay plan/series/grade, tenure and the type of appointment (i.e. competitive/excepted). In some cases you may need to submit more than one SF-50.
Reference the "Required Documents" section for additional requirements.
IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE.
Applicants must have 52 weeks of specialized experience equivalent to at least the next lower grade level, GS-12, in the Federal Service.
Examples of specialized experience are as follows:
1. conducting routine audits and implementing internal controls on various program activities;
2. analyzing data and special studies to identify and prevent fraud, waste and/or abuse; and
3. researching and assessing healthcare administration laws and policies to determine the impact of emerging issues on agency system requirements and processes.
There is no Education requirement or substitution at this grade level.
DOL seeks to attract and retain a high performing and diverse workforce in which employees’ differences are respected and valued to better meet the varying needs of the diverse customers we serve. DOL fosters a diverse and inclusive work environment that promotes collaboration, flexibility and fairness so that all individuals are able to participate and contribute to their full potential.
Refer to these links for more information: GENERAL INFORMATION, ADDITIONAL DOCUMENTATION, FORMER FEDERAL EMPLOYEES
You will be evaluated for this job based on how well you meet the qualifications above.
Click here for Evaluation details. For Displaced Employees ONLY: if you meet the eligibility requirements for special priority selection under ICTAP/CTAP, you must be well-qualified for the position to receive consideration for special priority selection. ICTAP/CTAP eligibles will be considered "well-qualified" if they attain at least a rating score of 85 in a numerical rating scheme. Be sure to review DOL Account Eligibility Questions #24 and 27 to reflect that you are applying as an ICTAP/CTAP eligible and submit supporting documentation.
Evaluation Factors (Competencies) - All qualified applicants will be evaluated on the following key competencies:
Technical Competence: Uses knowledge that is acquired through formal training or extensive on-the-job experience to perform one's job; works with, understands, and evaluates technical information related to the job; advises others on technical issues.
Problem Solving: Identifies and analyzes problems; distinguishes between relevant and irrelevant information to make logical decisions; provides solutions to individual and organizational problems.
Communication Skills: Communicates in a clear, concise, organized and convincing manner for the intended audience.
The information you provide may be verified by a review of your work experience and/or education, by checking references and through other means (ex. interview). Your evaluation may also include a review by an HR Specialist or panel and may include other assessment tools (ex. interview, structured interview, written test, work sample, etc). The examining Human Resources Office (HRO) makes the final determination concerning applicant ratings. Your resume MUST provide sufficient information to substantiate your vacancy question responses. If not, the HRO may amend your responses to more accurately reflect the level of competency indicated by the content of your resume.
The following documents must be submitted by 11:59 p.m. (ET) on the vacancy closing date. Warning: If you submit a document using the same document title, the 2nd submission will OVERWRITE the 1st submission. Also, do not upload password protected documents. Follow the instructions: click How To Submit Supplemental Documentation Document.
The following documents are required from all applicants (PLEASE READ CAREFULLY):
ARE YOU A CURRENT OR FORMER FEDERAL EMPLOYEE? If applying as a status candidate with current or former Federal Service, please provide a copy of your last or most recent SF-50, "Notification of Personnel Action” which shows your appointment eligibility for the position for which you are applying. Your SF-50 must identify the highest grade you held on a permanent basis, Pay Plan/Pay Schedule, Series, and Grade/Pay Band, and career status. Multiple SF-50 may be submitted to demonstrate your highest previous rate and eligibility.
*WARNING: An award SF-50 (ex. cash or time off award) may not indicate grade, step and competitive status. For current DOL employees, an award SF-50 DOES NOT indicate grade and step.
- Most recent performance appraisal/evaluation signed and dated within 18 months is requested by the agency, but will not disqualify candidates if not submitted. If not submitted during the application process, one may/will be requested at the time of the interview if the opportunity is extended. Applies to current and former Federal employees.
- Land Management Eligibles: a copy of your most recent Notification of Personnel Action (SF-50 or equivalent) proving your eligibility for appointment under the Land Management Workforce Flexibility Act. This service must have been performed in the competitive service, under a time limited appointment in a Land Management Agency, as defined by P.L. 114-328. For more information, click here.
The following documents are required if applicable:
- Displaced Employee Placement Documents - Only required if requesting priority consideration under ICTAP/CTAP Eligibility.
- DD-214 - verifying military service, eligibility for consideration under the Veterans Employment Opportunity Act (VEOA) and showing character of discharge (ex. Member Copy 4 and 2 are acceptable vs. Copy 1 which is not acceptable to adjudicate veteran's preference)
- Special/Non-Competitive Appointing Authority Documents - Applicants who are eligible for consideration, and wish to be considered, under one of the following non-competitive hiring authorities must submit appropriate documentation (click on the links below to see the documentation requirements):
(a) Military Spouses (MISP)
- Cover Letters are not mandatory and will not be used to verify experience, but may be submitted
Applicants selected for employment who are not current DOL employees will be required to provide proof of citizenship, and the E-Verify system will be used to confirm the employment eligibility of all new hires.
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.
To apply for this position, you must complete the initial online application, to include submission of the required documentation specified in the Required Documents section.
Note: If you are unsure, refer to your last or most recent Notification of Personnel Action (SF-50) or ask your servicing Human Resources Specialist.) If you don’t know what type of appointment you are on, you may find copies of your SF-50s in your electronic personnel folder (eOPF).
Follow the steps below to apply. Your application and ALL required supplemental documents MUST be received by 11:59 pm Eastern Time (ET) on the vacancy closing date to receive consideration. Paper applications and supplemental documents submitted in any other manner without prior approval from the vacancy contact will not be considered. Click here for information on Reasonable Accommodations.
SAVE your information before the 30 MINUTE TIMEOUT! For help, go to https://www.usajobs.gov/Help/how-to/.
STEP 1 - Create USAJOBS Account on www.usajobs.gov, including Resume and Saved Documents
Your resume must provide sufficient information to substantiate your responses in the self-assessment vacancy questions. If not, HR may amend your responses to more accurately reflect the competency indicated by resume content. FOR EACH EMPLOYMENT PERIOD, include: start/end month & year and note full-time or part-time (if part-time, include # of hours worked per week); otherwise, your application may be considered incomplete.
STEP 2 - Complete the 1st part of the application process (USAJOBS)
Once you have identified a job on www.usajobs.gov that you wish to apply for, click on the title and click the Apply button . For questions about the vacancy, contact the Agency Contact at the bottom of the announcement. Click “Start Application” and proceed through 5 steps noted at the top of the USAJOBS page. You will be able to select a resume and documents from your USAJOBS Account that you can submit as a package as part of your DOL application. At Step 5, click “Continue to Agency Site”.
STEP 3 – Complete the 2nd part of the application process (DOL)
On the Department of Labor (DOL) page, create a DOL Account if you have not already and click “APPLY TO THIS VACANCY”. Continue through the 7 progress steps indicated by circles at the top of the DOL page. The 3rd progress step is where you answer the vacancy specific questions. The 4th progress step "Documents" is where you submit required documents (only if applicable to you) specified in the "Required Documents" section of this vacancy. If you submit a document using the same document title, the 2nd submission will OVERWRITE the 1st submission.
STEP 4 – On the “Review and Submit” step, click “Submit Application”
The last “Confirmation” step will turn green noting that your application was submitted successfully.
STEP 5 - Edit Application as needed by 11:59 pm ET of Closing Date by returning to USAJOBS, clicking the vacancy, then “Update Application”.
Once your complete application is received, we will conduct an evaluation of your qualifications and refer candidates for selection consideration. Candidates will be referred to the hiring manager for further consideration and possible interview. You will be notified of the outcome. A selection is expected to be made within 30 calendar days from the issuance date of the certificate.
For instructions on how to check the status of your application, go to Step 7 on: Using DOORS and USAJOBS Help Guide. To sign up for Application Status Updates via email: Click Here for instructions.
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/job/528071100. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.
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