Clarification from the agency

This position is being filled using a Direct-Hire Authority (DHA), it is open to all U.S. Citizens.

• Review treatment requests submitted by physicians.
• Assist medical director in developing medical policy for treatment authorization.
• Serve as a customer service representative with clinical directors and administrators.
• Provide clinical guidance and documentation required to obtain authorization for treatment benefits.
• Participate in process improvement, quality assurance, and adherence to medical policy.
• Manage documentation of clinical decisions.
• Coordinate and update document management database.
• Provide updates on projects and status of weekly certifications.

Conditions of employment

• US Citizenship is required.
• Background Investigation is required.
• E-Verify: If you are selected for this position, the documentation that you present for purposes of completing the Department of Homeland Security (DHS) Form I-9 will be verified through the DHS "E-Verify" System. Federal law requires DHS to use the E-Verify System to verify employment eligibility of all new hires, and as a condition of continued employment obligates the new hire to take affirmative steps to resolve any discrepancies identified by the system. The U.S. Department of Health and Human Services is an E-Verify Participant.
• Direct Deposit: All Federal employees are required to have Federal salary payments made by direct deposit to a financial institution of their choosing.
• All qualification requirements must be met by the closing date of the announcement.
• One-year probationary period may be required.
• Travel, transportation, and moving expenses will be paid: No
• Relocation authorized: No
• Bargaining Unit Position: Yes
• Drug Screening Required: No
• Promotion potential: No
• Supervisory position: No
• Public Trust/Moderate Background Investigation (5) is required
• Current or Former Political Appointees: Agencies must seek prior approval from the Office of Personnel Management (OPM) before they can appoint a current or recent political appointee to a competitive or non-political excepted service position at any level under the provisions of title 5, United States Code. If you are currently, or have been within the last 5 years, a political Schedule A, Schedule C, or Non-career SES employee in the executive branch, you MUST disclose that to the Human Resources Office. Failure to disclose this information could result in disciplinary action including removal from Federal Service. Current or Former Political Appointees: Submit SF-50.

Qualifications

Basic Qualification Requirements for the Nurse Consultant GS-0610-12:

A graduate or higher level degree, bachelor's degree, associate degree, or diploma from an accredited professional nursing educational program. This education must have been accredited by the Commission on Collegiate Nursing Education, Council on Accreditation of Nurse Anesthesia Educational Programs, Accreditation Commission for Midwifery Education, or an accrediting body recognized by the U.S. Department of Education at the time the degree was obtained.

OR

Degree from a Foreign Nursing School: Official certification from the Commission on Graduates of Foreign Nursing Schools is required for individuals who graduated from foreign nursing schools.

OR

A graduate or higher level degree in nursing from an accredited educational program in the area of expertise or specialty indicated by the position. Areas of specialties for positions include, but are not limited to, Acute Care, Anesthesia, Community Health, Family, Geriatric, Home Health, Midwifery, Neonatal, Oncology, Pediatric, Psychiatric, Allergy and Immunology, Women's Health, Cardiovascular, Dermatology, Occupational Health, Orthopedic, Respiratory, or other specialties identified for the position.

Additional Basic Qualification Requirements for Nurse GS-0610-12:

Have passed the National Council Licensure Examination. In addition, I possess a current, active, full, and unrestricted license or registration as a professional nurse from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

OR

Licensed or registered by a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States in the clinical specialty required by the position.

Minimum Qualifications:

In addition to meeting the Basic Qualifications listed above, applicants must also possess at least one year of specialized experience at or equivalent to the GS-11 in the Federal service as defined in the next paragraph.

Specialized experience is experience which is directly related to the position which has equipped the applicant with the particular knowledge, skills and abilities (KSAs) to successfully perform the duties of the position to include experience determining the medical necessity and appropriateness of a physician's request for authorization of treatment; evaluating the patients diagnoses, symptoms, and dates of onset; while applying the rules, regulations, and policies of the health care plan in making the determination.

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, 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.

*In accordance with Executive Order 12564 of September 14, 1986, The Department of Health and Human Services (HHS) is A Drug-Free Federal Workplace. The Federal government, as the largest employer in the Nation, can and should show the way towards achieving drug-free workplaces through programs designed to offer drug users a helping hand, and at the same time demonstrating to drug users and potential drug users that drugs will not be tolerated in the Federal workplace. The use of illegal drugs, on or off duty, by Federal employees is inconsistent not only with the law-abiding behavior expected of all citizens, but also with the special trust placed in such employees as servants of the public. Applicants tentatively selected for this position may be required to submit to urinalysis to screen for illegal drug use prior to appointment and be subject to reasonable suspicion and post-accident drug testing upon hiring. If required to submit to urinalysis, the appointment to the position will be contingent upon a negative applicant drug test result. In order to demonstrate commitment to the HHS goal of a drug-free workplace and to set an example for other Federal employees, employees not in a testing designated position may volunteer for unannounced random testing by notifying their Drug-free Federal Workplace Program Point of Contact upon hiring.

How you will be evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

"Additional selections may be made for similar positions across the Department of Health and Human Services (HHS) within the local commuting area(s) of the location identified in this announcement. By applying, you agree to have your application shared with interested selecting official(s) at HHS. Clearance of CTAP/ICTAP will be applied for similar positions across HHS."

Once the application process is complete, a review of the resume and supporting documentation will be made and compared against your responses to the assessment questionnaire to determine if you are qualified for this job. If, after reviewing your resume and/or supporting documentation, a determination is made that you have inflated your qualifications and/or experience, you may lose consideration for this position. Please follow all instructions carefully. Errors or omissions may affect your eligibility.

Your qualifications will be evaluated on the following competencies (knowledge, skills, abilities and other characteristics).

• Clinical Knowledge and Skills (2)
• Nursing Knowledge