Oversees a specialized funding program for a health care center on the Confederated Tribes of the Colville Indian Reservation. The program assists patients in funding health needs beyond that available at the center. Work includes analyzing effectiveness of program, ensure available funding, regular reports and supervise others who pay claims.
This job announcement is OPEN UNTIL FILLED. Job announcement closes once the position is filled.
Recruitment or relocation incentives may be paid.
Summary
Oversees a specialized funding program for a health care center on the Confederated Tribes of the Colville Indian Reservation. The program assists patients in funding health needs beyond that available at the center. Work includes analyzing effectiveness of program, ensure available funding, regular reports and supervise others who pay claims.
This job announcement is OPEN UNTIL FILLED. Job announcement closes once the position is filled.
The IHS is required by law to give absolute preference to qualified applicants who meet the Secretary of the Interior's definition of Indian for appointment to vacancies within the IHS in accordance with established IHS policy as outlined in the Indian Health Manual Part 7, Chapter 3. The IHS is an Equal Opportunity Employer.
Visit the website for information on the Indian Health Service Agency special funding program called Purchasing/Referral Care (PRC). The website provides information to American Indian/Alaska Native (AI/AN) patients on the PRC program requirements for medical/dental care.
Major duties of the Purchase, Referred Care Office (PRC) Administrator:
Develop management systems to provide effective and appropriate complex paperwork systems necessary to process thousands of individual cases in accordance changing requirements.
Supervises the PRC program staff.
Provides to the Chief Executive Officer or Deputy Chief Executive Officer and the PRC Committee a weekly spending plan.
Responsible for the sound fiscal management of the PRC Program.
Makes determinations and develops policies regarding the extent of service unit participating in costs of medical care for authorized clients.
Develops for submission any potential Catastrophic Health Emergency Fund cases.
Carries out necessary work to ensure the maximum utilization of alternate resources for major and non-routine cases.
Makes efforts to develop other programs and locate other resources to fill unmet health needs due to limitations of the PRC funding.
Works with others in development and operation of a variety of health service contracts with local hospitals, clinics, individual consultants, pharmacies, locum agencies to maximize the service and cost effectiveness of health services.
Interprets the PRC Program to patients/consumers, partners, and vendors in accordance with appropriate laws, regulations and policies.
Trains or meets on regular basis with participating health care providers.
Formulates service unit budget requests for contract services. Provide data for the CSU budget formation for the Governing Board.
Identifies significant deviations from the approved IHS National and PAO direction projected plans, complies supportive data; revises budgetary requirements and writes requests for budget adjustments for the review and formal presentation to the CEO when supplemental funds are required.
Participates on national committees to remain current on the PRC program operations.
Selectee may be subject to a probationary period
U.S. Citizenship is required
Selective Service Registration is required for males born after 12/31/1959
This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children. Due to this requirement, the agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes.
Measles and Rubella immunization required for selectees born after 1957 and seasonal influenza immunization is required for all staff working in Indian Health Service health care facilities.
COVID-19 vaccination is required for all selectees prior to entrance on duty.
The selected individual is required to obtain and maintain medical staff clinical privileges, including any licensure requirements. If privileges are not obtained or maintained during employment, the employee will be subject to adverse actions, up to and including removal from Federal service.
Successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit www.dhs.gov/E-Verify/.
You will need to set up direct deposit so we can pay you.
Background Investigation: If you are selected for this vacancy, you must undergo a pre-employment fingerprint check and background investigation. Fingerprint results and background investigation documentation must be cleared prior to hire. After you begin your employment, your continued employment is contingent upon the outcome of a complete background investigation as determined by the sensitivity level of your position. The investigation must find that you are suitable for Federal employment in your position. If you are found not suitable, you will be terminated after you begin work. If you make a false statement in any part of your application, you may not be hired; you may be fired after you begin work; or subject to possible criminal charges. You may be subject to a credit check as a part of the background investigation process.
Qualifications
To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying.
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; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week.
MINIMUM QUALIFICATIONS FOR GS-11:
Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the grade GS-09, which is the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks such as: work experience in managing a program that includes the accounting of money accounts reporting and maintenance, and the processing of claims for the government health facility or private health insurance group.OR
Submit a copy of unofficial transcripts to show completed a Ph.D. or equivalent doctoral degree or 3 full years of progressively higher-level graduate education leading to such a degree or LL.M., if related. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work. OR
Demonstrate meeting qualifications for this grade level by indicating on resume and submitting a copy of unofficial transcripts to show a combination of specialized experience and graduate level education that meets 100% of the qualification requirements for this position.
Specialized Experience: Experience that equipped the applicant with the particular knowledge, skills, and abilities to perform successfully the duties of the position, and that is typically in or related to the work of the position to be filled.
You must meet all qualification requirements within 30 days of the cut-off date or the closing date of the announcement. The first cutoff date is 10 days after the opening date. If necessary, additional cutoff dates will be established until the position is filled. Once the position is filled, the job announcement closes.
Education
Substitution of Education for Experience or Combing Education with experience to qualify for the GS-11 grade is a Ph.D. or equivalent doctoral degree or 3 full years of progressively higher-level graduate education leading to such a degree or LL.M., if related. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work.
Graduate Education: Education at the graduate level in an accredited college or university i meets the requirements for positions at GS-7 through GS-11. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work.
One year of full-time graduate education is considered to be the number of credit hours that the school attended has determined to represent 1 year of full-time study. If that information cannot be obtained from the school, 18 semester hours should be considered as satisfying the 1 year of full-time study requirement.
Part-time graduate education is creditable in accordance with its relationship to a year of full-time study at the school attended.
Additional information
Per IHS policy (SGM 21-04) IHS selectees to positions located in Federally operated hospitals, health centers, and clinics must be fully vaccinated for COVID-19 before entry on duty or have IHS approve a medical or religious exemption. If an exemption is approved then wearing a face mask and regular testing for COVID-19 will be required. Your Human Resources Specialist will provide a list of documents acceptable as vaccination proof and instructions on how to submit your vaccination documentation or how to request a medical or religious exemption, if needed.
This position is eligible for workplace flexibilities which may include remote work or telework options, and/or flexible work scheduling. These flexibilities may be requested in accordance with the HHS Workplace Flexibilities policy. https://www.hhs.gov/about/agencies/asa/ohr/hr-library/990-1/index.html.
Additional selection(s) of candidates may be possible within 240 days from the date the certificate of eligibles was issued for this announcement.
Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. IHS may offer newly-appointed Federal employees credit for their directly related previous non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave.
Recruitment or relocation incentives may be authorized. At least a 6 month service agreement will be required.
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 requirements for this position, your application will be evaluated and rated under Category Rating selection procedures. Once the application process is complete, a review of your qualifications will be conducted to determine if you are qualified for this job. Qualified candidates will be assigned to a quality category. The quality categories are: Best Qualified, Well Qualified, or Qualified. Within each of these categories, applicants eligible for veteran's preference will receive selection priority over non-preference eligibles.
Please note that if, after reviewing your resume and or supporting documentation, a determination is made that you have inflated your qualifications and or experience, your category rating can and will be adjusted to more accurately reflect your abilities, or you may lose consideration for this position. Please follow all instructions carefully. Errors or omissions may affect your eligibility.
To determine if you are qualified for this position, a review of your resume and supporting documentation will be made and compared against the qualifications as defined in the qualifications section of this vacancy announcement and your responses to the assessment questions. You will be rated based on the information provided in your resume (your resume must state specific duties that relate to this position) and your responses to the assessment questions will be evaluated against the duties you provided in your resume, along with your submitted documentation to determine your ability to demonstrate the following.
Financial Analysis
Financial Management
Health Claims Processor
Manages Human Resources
Planning and Evaluating
Technology Application
The following links below provide information on how you may be eligible for various hiring authorities. If you are a Veteran, qualified CTAP and ICTAP eligible, or an individual with a disability, please refer to the following links below for additional guidance. CTAP and ICTAP candidates will be eligible for selection priority if it is determined that they have exceeded the minimum qualifications for the position by attaining at least a "well qualified" rating of 85 out of 100. Information about CTAP and ICTAP eligibility is on the Office of Personnel Management's Workforce Restructuring Career Transition website at: https://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/. CTAP/ICTAP documentation requirements are listed in the "Required Documents" section of this announcement.
Click here to view vacancy questions: https://apply.usastaffing.gov/ViewQuestionnaire/12527721. All documents above MUST be received by 11:59 pm (Eastern Standard Time) of the cut-off date or the closing date of, 12/31/2024, to be considered. The first cutoff date is 10 days after the opening date. If necessary, additional cutoff dates will be established until the position is filled.
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.
Resume: You are highly encouraged to use USAJOBS Resume Builder to ensure all required information is included in your Resume. If you use your own resume, curriculum vitae, or any other written form you choose then you must describe your job-related qualifications that includes
beginning and ending dates for paid and non-paid work experience,
hours worked per week,
month and year of employment for each job title listed,
description of job duties.
Include name and address of employer, supervisor name and telephone number.
Required as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements:
Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only." Indian preference will not be given unless a properly signed and dated form is submitted with your application, including any verification by an authorized Tribal Representative or BIA Official of tribal enrollment records. For detailed instructions, see form BIA-4432. Refer to BIA-4432 link: https://www.bia.gov/sites/default/files/dup/assets/public/raca/online_forms/pdf/1076-0160_INDIAN-PREF_Expires-10.31.24_508.pdf. When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference.
Veterans Preference: If claiming Veteran's Preference provide a copy of your DD214 Form (Member 4 copy). To claim 10-Point Veterans Preference, submit a SF-15 Application (http://www.opm.gov/forms/pdf_fill/SF15.pdf) along with the appropriate supporting documentation. For additional information regarding Veterans Preference visit: http://www.fedshirevets.gov.
Transcripts: You are encouraged to submit copies of transcripts (official or unofficial) although not required at the time of application. You must list your courses including titles, credit hours completed, and grades. Official transcripts will be required after tentative selection and prior to issuing an official job offer.
Licensure, Certifications: Applicants should list their license/certifications on their resume, along with the expiration date, if applicable. Certification of licensure/certification will be required after tentative selection and prior to issuing an official job offer.
You must meet the requirements of the job by 11:59 (Eastern Standard Time) of the cut off date or the closing date: 12/31/2024
The first Cut-off date for receipt/referral of applications to be considered for available vacant positions will be 10 days after the JOA open date. If necessary, additional cutoff dates will be established until the position is filled.
Your resume and any documents submitted will be retained for three months and may be used at any time during this period. After 3 months, you must reapply to this announcement in order to be considered.
Colville Service Unit
PO Box 71
HWY 155 Agency Campus
Nespelem, WA 99155
US
Next steps
You can track the progress of your application package via your USAJobs account. You will receive an acknowledgement from USAJobs that your submission was successful once we have received your on-line occupational questionnaire, resume, and any supporting documentation. You will be notified of the status of your application via your USAJobs Account after we conduct a qualification review of your complete application package. You will be contacted if further evaluation or interviews are required. Any exaggeration of your experience, false statements, or attempt to conceal information may disqualify you for employment consideration. We may verify all information you provide in your resume and questionnaire responses, through reference and/or background check, and/or verification of your education. If you are selected, you will be contacted personally by the human resources office posting this announcement.
If all required documentation is not submitted with your application you will lose consideration. It is the applicant's responsibility to verify that information and documents entered, uploaded, or faxed are received, legible and accurate. HR will not modify answers submitted by an applicant.
HHS has a critical preparedness and response mission: HHS protects the American people from health threats, researches emerging diseases, and mobilizes public health programs with domestic and international partners. In support of this mission, HHS offers its employees the opportunity to volunteer to become Federal Civilian Detailees and contribute their unique skills through voluntary temporary assignments to humanitarian emergencies or Departmental priorities countering new and emerging health, safety, and security threats.
~ ~ ~ Indian Health Service is an Equal Opportunity Employer ~ ~ ~
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
Resume: You are highly encouraged to use USAJOBS Resume Builder to ensure all required information is included in your Resume. If you use your own resume, curriculum vitae, or any other written form you choose then you must describe your job-related qualifications that includes
beginning and ending dates for paid and non-paid work experience,
hours worked per week,
month and year of employment for each job title listed,
description of job duties.
Include name and address of employer, supervisor name and telephone number.
Required as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements:
Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only." Indian preference will not be given unless a properly signed and dated form is submitted with your application, including any verification by an authorized Tribal Representative or BIA Official of tribal enrollment records. For detailed instructions, see form BIA-4432. Refer to BIA-4432 link: https://www.bia.gov/sites/default/files/dup/assets/public/raca/online_forms/pdf/1076-0160_INDIAN-PREF_Expires-10.31.24_508.pdf. When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference.
Veterans Preference: If claiming Veteran's Preference provide a copy of your DD214 Form (Member 4 copy). To claim 10-Point Veterans Preference, submit a SF-15 Application (http://www.opm.gov/forms/pdf_fill/SF15.pdf) along with the appropriate supporting documentation. For additional information regarding Veterans Preference visit: http://www.fedshirevets.gov.
Transcripts: You are encouraged to submit copies of transcripts (official or unofficial) although not required at the time of application. You must list your courses including titles, credit hours completed, and grades. Official transcripts will be required after tentative selection and prior to issuing an official job offer.
Licensure, Certifications: Applicants should list their license/certifications on their resume, along with the expiration date, if applicable. Certification of licensure/certification will be required after tentative selection and prior to issuing an official job offer.
You must meet the requirements of the job by 11:59 (Eastern Standard Time) of the cut off date or the closing date: 12/31/2024
The first Cut-off date for receipt/referral of applications to be considered for available vacant positions will be 10 days after the JOA open date. If necessary, additional cutoff dates will be established until the position is filled.
Your resume and any documents submitted will be retained for three months and may be used at any time during this period. After 3 months, you must reapply to this announcement in order to be considered.
Colville Service Unit
PO Box 71
HWY 155 Agency Campus
Nespelem, WA 99155
US
Next steps
You can track the progress of your application package via your USAJobs account. You will receive an acknowledgement from USAJobs that your submission was successful once we have received your on-line occupational questionnaire, resume, and any supporting documentation. You will be notified of the status of your application via your USAJobs Account after we conduct a qualification review of your complete application package. You will be contacted if further evaluation or interviews are required. Any exaggeration of your experience, false statements, or attempt to conceal information may disqualify you for employment consideration. We may verify all information you provide in your resume and questionnaire responses, through reference and/or background check, and/or verification of your education. If you are selected, you will be contacted personally by the human resources office posting this announcement.
If all required documentation is not submitted with your application you will lose consideration. It is the applicant's responsibility to verify that information and documents entered, uploaded, or faxed are received, legible and accurate. HR will not modify answers submitted by an applicant.
HHS has a critical preparedness and response mission: HHS protects the American people from health threats, researches emerging diseases, and mobilizes public health programs with domestic and international partners. In support of this mission, HHS offers its employees the opportunity to volunteer to become Federal Civilian Detailees and contribute their unique skills through voluntary temporary assignments to humanitarian emergencies or Departmental priorities countering new and emerging health, safety, and security threats.
~ ~ ~ Indian Health Service is an Equal Opportunity Employer ~ ~ ~
Fair and transparent
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
