This position is located in the U.S. Department of Labor (DOL), Office of Workers’ Compensation Programs (OWCP), Division of Administrative Operations (DAO), Branch of Medical Standards and Rehabilitation (BMSR), Washington, DC.
Summary
This position is located in the U.S. Department of Labor (DOL), Office of Workers’ Compensation Programs (OWCP), Division of Administrative Operations (DAO), Branch of Medical Standards and Rehabilitation (BMSR), Washington, DC.
All U.S. Citizens, ICTAP/CTAP in the local commuting area.
This is a dual announcement also advertised under MS-19-PHIL-OWCP-0123, to be considered under both announcements, you must apply to both.
OWCP administers four critical benefit programs [Federal Employees' Compensation Act (FECA) program; the Longshore and Harbor Workers’ Compensation Act (LHWCA) program; the Black Lung Benefits Act program; and the Energy Employees' Occupational Illness Compensation Program (EEOICP)] for workers who become ill or are injured on the job by ensuring income support for these workers when work is impossible or unavailable due to their injury or illness.
DOL encourages persons with disabilities to apply, including eligible under 5 CFR 213.3102(u), Schedule A [i.e. intellectual disabilities, severe physical disabilities, or psychiatric disabilities]. & Disabled veterans with a compensable service-connected disability of 30% & more.
-This position is outside the bargaining unit.
-Additional selections may be made from this announcement.
DUTIES
Provides oversight and direction regarding the development, implementation, and operation of the OWCP Medical Bill Processing System and related system functions and activities [e.g., medical provider registration, claimant and provider inquiries, central mailroom activities, PBM services, fiscal operations, program integrity, and medical bill coding]. This nationwide system improves the day-to-day strategic management of OWCP business operations. Fosters communication and working relationships with respective Physicians, Information Systems Development Officers (ISDO), Contracting Officer’s Representatives (COR), and Program liaisons in planning and directing transition/modernization operations to a new medical bill payment system. Provides continuity, assistance, and guidance to OWCP subject matter experts and ensures that all requisite requirements have been met.
Serves as the OWCP authority for the Agency’s medical bill and pharmacy processing systems. In this capacity, the incumbent has overall responsibility for overseeing the design, development, testing, and evaluating lifecycle phases;establishing short- and long-term system objectives; setting and adjusting priorities; ensures ongoing modifications are implemented in the systems and changes in procedures are made compatible with OWCP programs; oversees research and analytical efforts designed to identify and address overall system problems arising during system development that impact current business practices and ensures solutions work for all system users and OWCP objectives and goals are not adversely impacted. Designs reporting methods and monitors system performance through various means(e.g., performance reporting, trend analysis, and internal and external stakeholder surveys/feedback).
Formulates, develops, and implements appropriate policies and procedures for the OWCP Medical Bill Processing System as well as special procedural and policy needs of individual programs. Consults with Physicians in determining new or revised policy and procedural guidance for effective medical system operation. Makes recommendations to specific OWCP Programs’ policies and procedures as new system requirements are identified and Program feedback is received to ensure complete alignment.
Serves as a principal advisor to OWCP executive leadership by providing information within area of expertise to make informed decisions concerning program integrity, objectives, and the prevention and detection of fraud, risk, and abuse. Consults with the Office of Inspector General (OIG) regarding potential fraud and abuse in the amounts and types of medical treatment, costs, and pharmaceuticals relative to workers’ compensation.
As the Branch Chief, the incumbent provides oversight for all strategic planning initiatives regarding the OWCP Medical Bill Processing System, which includes pharmacy benefits management, medical treatment guidelines, and medical fee schedule methodologies.
Provides oversight of the pharmaceutical aspects of the medical bill processing system and PBM. Renders subject matter advice and expertise on the therapeutics and economics of drug treatments; approval or rejection of PBM service provider recommendation; the development and maintenance of formularies and exclusion lists; the development of drug-related policies and procedures; and the use of prescription and non-prescription drugs.
Assists in preparing the Secretary and OWCP Director for the presentation of testimony before Congress and/or may be called upon to provide direct testimony. Assists in the design and development of reports, papers, or other materials to Congress. Guides the preparation of the Secretary and OWCP Director for testimony and engagement.
Candidate required to obtain the necessary security/investigation level.
Appointment to this position may require a background investigation.
Subject to financial disclosure requirements.
Requires a probationary period if the requirement has not been met.
Must be at least 16 years old and a U.S. Citizen.
Applicants must meet all legal and regulatory requirements. Reference the "Required Documents" section for additional requirements.
Qualifications
“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-14, in the Federal Service.
Specialized experience is defined as:
Experience directing and advising subordinates to include both licensed medical professionals (i.e., doctors, pharmacists and nurses) and/or non-medical personnel(i.e., medical coding specialist, analysts and workers compensation specialists) on centralized medical/pharmaceutical/healthcare bill processing and payment systems.
Experience in applying quality management principles, laws and regulations in the development, implementation and revision of policies and procedures pertaining to medical and pharmacy benefits payment systems processing (relating to industry standards).
Experience managing the development and implementation of internal controls based on medical audit findings to prevent and detect fraud, waste and abuse in a healthcare setting.
Education
There is no educational substitution for this position at this grade level.
Additional information
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.
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, you will be evaluated against the evaluation factors below and will be placed into a category based on your vacancy question responses.
Categories
Category A - Meets the basic qualification requirements for the vacancy and has successful experience in the same or similar job that has demonstrated superior proficiency in applying critical competencies required by this position to work of increased levels of difficulty and complexity.
Category B - Meets the basic qualification requirements for the vacancy and demonstrates satisfactory proficiency in the critical competencies required by this position.
Category C - Meets the specialized experience described in the minimum qualifications requirements section of this announcement and demonstrates proficiency in the basic competencies.
Evaluation Factors (Competencies) - All qualified applicants will be evaluated on the following key competencies:
-Technical Credibility - Understands and appropriately applies principles, procedures, requirements, regulations and policies related to specialized expertise.
-Project Management- Knowledge of the principles, methods, or tools for developing, scheduling, coordinating, and managing projects and resources, including monitoring and inspecting costs, work, and contractor performance.
-Leadership - Influences, motivates and challenges others; adapts leadership styles to a variety of situations.
-Communications - Expresses ideas and facts to individuals or groups effectively; makes clear and convincing presentations; listens to others; facilitates an open exchange of ideas.
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). The examining Human Resources Office (HRO) makes the final determination concerning applicant ratings. Your resume MUST provide sufficient information to substantiate your responses to the vacancy questions. If not, the HRO may amend your responses to more accurately reflect the level of competency indicated by the content of your resume. Your evaluation may also include a review by a Human Resources Specialist or panel and may include other assessments (ex. interview, panel review, written test, writing sample, etc.)
INFORMATION FOR ICTAP/CTAP ELIGIBLES ONLY: If you are eligible for special priority selection under ICTAP/CTAP, you must be well-qualified for the position to receive consideration. ICTAP/CTAP eligibles who are placed into Category B or higher will be considered "well-qualified".
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.
The following documents must be submitted by 11:59 p.m. (ET) on the vacancy closing date. You are not required to submit a document if it does not apply to you. 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.
- Veterans Documents (if applicable): To be considered as a 5-point preference eligible, you must submit a copy of your Certificate of Release or Discharge From Active Duty, DD214. Your DD-214 must show the type of discharge and dates of active duty. To claim 10-point preference, you must submit a copy of your DD214; an Application for 10-point Veteran's Preference, SF15; and the proof of entitlement of this preference which is normally an official statement, dated 1991 or later, from the Department of Veterans Affairs certifying to the present existence of the service-connected disability and indicating the percentage of your disability. (For active duty service members expecting honorable or general discharge or release within 120 days, click Active Duty). Without this documentation, you will not receive veteran's preference. For more information, go to: http://www.fedshirevets.gov/hire/hrp/vetguide/index.aspx
- Displaced Employee Placement Documents – Only required if requesting priority consideration under CTAP or ICTAP eligibility.
- 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.
If you are relying on your education to meet qualification requirements:
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.
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”.
Labor, Ofc of Workers' Compensation Programs
The Curtis Center
170 S. Independence Mall West
Suite 600 East
Philadelphia, Pennsylvania 19106
United States
Next steps
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.
The following documents must be submitted by 11:59 p.m. (ET) on the vacancy closing date. You are not required to submit a document if it does not apply to you. 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.
- Veterans Documents (if applicable): To be considered as a 5-point preference eligible, you must submit a copy of your Certificate of Release or Discharge From Active Duty, DD214. Your DD-214 must show the type of discharge and dates of active duty. To claim 10-point preference, you must submit a copy of your DD214; an Application for 10-point Veteran's Preference, SF15; and the proof of entitlement of this preference which is normally an official statement, dated 1991 or later, from the Department of Veterans Affairs certifying to the present existence of the service-connected disability and indicating the percentage of your disability. (For active duty service members expecting honorable or general discharge or release within 120 days, click Active Duty). Without this documentation, you will not receive veteran's preference. For more information, go to: http://www.fedshirevets.gov/hire/hrp/vetguide/index.aspx
- Displaced Employee Placement Documents – Only required if requesting priority consideration under CTAP or ICTAP eligibility.
- 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.
If you are relying on your education to meet qualification requirements:
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.
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”.
Labor, Ofc of Workers' Compensation Programs
The Curtis Center
170 S. Independence Mall West
Suite 600 East
Philadelphia, Pennsylvania 19106
United States
Next steps
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.
