• Manage implementation and compliance of Health Information Portability and Accountability Act (HIPAA) provisions, Privacy Act constraints, and all other applicable Protected Health Information (PHI) laws and regulations.
• Determine impact of patient privacy on the organization by analyzing federal, state, agency and local laws, regulations, and policies.
• Coordinate with personnel to ensure they have a complete understanding of policies, procedures, and legal requirements regarding Protected Health Information (PHI).
• Analyze information to determine and/or verify the occurrence of a violation; present results and recommendations for action to leadership and applicable legal authorities.
• Advise beneficiaries, outside agencies, providers and medical professionals on matters related to health benefit programs, such as TRICARE, available to active duty, retired members and their dependents.
• Evaluate debt collection and billing issues for patients using a formal documentation process for tracking and resolution of issues.
• Conduct patient information privacy risk assessments to identify non-compliance with federal, state, local and departmental laws, policies and regulations.
• Advise on range of available benefits and entitlements as well as information on eligibility requirements, options, limitations covered by the TRICARE health care managed program.
• Conduct privacy training for all medical and professional, support and volunteer staff, contractors and other third parties.

Conditions of employment

• Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation.
• A Personnel Security Investigation is required.
• A one-year probationary period is required if the selectee has not previously met this requirement.
• Selectees will be required to sign a statement (Condition of Employment) consenting to seasonal influenza vaccinations or must provide a recognized exemption.
• Immunization screening is required. Hepatitis B immunization is required for all positions with direct patient contact. Applicants may be required to show proof of other immunizations depending on the type of position.
• Must be able to obtain and maintain current Basic Life Support (BLS) certification through the American Red Cross or American Heart Association. Advanced certification (e.g., ALS) does not supersede BLS.
• Applicants may be required to fulfill non-privileged professional credential requirements.

Qualifications

Who May Apply: US Citizens

In order to qualify, you must meet the education and/or experience requirements described below. 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). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document.

Basic Requirement for Health System Specialist:

Specialized Experience: One year of specialized experience which includes providing information on patient eligibility for medical/health services and Privacy Act (HIPPA) guidelines.This definition of specialized experience is typical of work performed at the second lower grade/level position in the federal service (GS-07).

OR

Education: Master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree in a field which demonstrates the knowledge, skills, and abilities necessary to do the work of the position, such as: Public Health, Health Science, Hospital Administration, Public Health Administration, Health Information Management. (Note: You must attach a copy of your transcripts.)

OR

Combination of Education and Experience: A combination of education and experience may be used to qualify for this position as long as the computed percentage of the requirements is at least 100%. To compute the percentage of the requirements, divide your total months of experience by 12. Then divide the total number of completed graduate semester hours (or equivalent) beyond the first year (total graduate semester hours minus 18) by 18. Add the two percentages.

How you will be evaluated

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

Once the announcement has closed, a review of your application package (resume, supporting documents, and responses to the questionnaire) will be used to determine whether you meet the qualification requirements listed on this announcement.

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 when applying, errors or omissions may affect your eligibility.

You should list any relevant performance appraisals and incentive awards in your resume as that information may be taken into consideration during the selection process. If selected, you may be required to provide supporting documentation.

Veterans and Military Spouses will be considered along with all other candidates.