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Contact Representative (PRC)

Department of Health and Human Services
Indian Health Service
Great Plains Area, Cheyenne River Health Center, Eagle Butte Hospital

Summary

Join our mission at the Cheyenne River Health Center, a premier HHS/IHS facility delivering safe, confidential, and high-quality healthcare. Located in Eagle Butte,South Dakota, our hospital provides timely, accessible medical services integrated with robust community education and preventative care.

A REAL ID will be required beginning May 7, 2025, in accordance with 6 C.F.R. 37.5 (2021).

Overview

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Accepting applications
Location
1 vacancy in the following location:
Work site options
Telework eligible
No
Remote job
No
Relocation expenses reimbursed
No
Salary
$45,409 - $72,644 per year
Pay scale & grade
GS 6 - 8
Promotion potential
8
Pay scale and grade determines the salary of the job.
Work schedule
Full-time
Travel Required
Occasional travel - You may be expected to travel for this position.
Appointment type
Permanent
Occupations and job series
Supervisory status
No
Federal service type
This job is in the Competitive Service
Represented by a union
Yes
Drug test
No
Security clearance
Other
Position sensitivity and risk
Moderate Risk (MR)
Jobs require a background check and some require a security clearance. The type depends on the job.
Background check type
Financial disclosure required
No
Some jobs require financial disclosure to identify conflicts of interests.
Announcement number
IHS-26-OHR-13042789-ESEP/MP
Control number
883577400

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Duties

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  • Receives notification and referrals for referred care.
  • Verifies and determines patient's eligibility for Medicare, Medicaid, private insurance, VA, or other potential alternative resources as appropriate.
  • Ensures that PRC funds are available prior to issuance of obligating documents on behalf of the government.
  • Initiates medical authorizations and denial of service for inpatient/outpatient/ancillary medical services for eligible beneficiaries.
  • Maintains complete fund control records for health services funds allotted.
  • Extracts statistical data from various software systems to prepare and submit reports.
  • Issues correspondence to patients, health care providers and other agencies regarding eligibility.
  • Reviews claims to determine if authorizations have been issued.

Requirements

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Conditions of employment

Selectee may be subject to a probationary period
ESEP appointees typically serve a two year trial 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.

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 Requirement:

This position requires the successful completion of a federal background investigation as a condition of employment.

A background investigation is a standard process used by the Federal Government to verify an individual's identity, employment history, education, and other relevant information to determine suitability for Federal service.

Upon receipt of instructions, applicants must complete all required background investigation forms within five (5) calendar days of issuance. Timely completion is critical to avoid delays in processing or a determination of unsuitability.

Applicants are strongly encouraged to prioritize this requirement and to maintain regular communication with their assigned Personnel Security Specialist throughout the process.

Financial Suitability Requirement:

This position requires a review of the applicant's financial history as part of the personnel security and suitability determination. Applicants must demonstrate financial responsibility, maintain good standing with creditors, and satisfy all legal financial obligations prior to applying.

Individuals with substantial delinquent or unresolved financial obligations-including, but not limited to, delinquent federal or state tax liabilities, defaulted federal student loans, court-ordered fines or fees, or child support arrears-may be deemed unsuitable for employment with the Indian Health Service (IHS).

Prior to the appointment, candidates must present two valid forms of identification. If one of the documents is a state-issued ID or driver's license, it must be REAL ID-compliant.

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:

GS-06:

Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least 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: identifying and verifying patient eligibility for Medicare, Medicaid, SSA benefits, private insurance, Tribal programs, and other assistance resources; interviewing patients to obtain required documentation; assisting individuals and families with benefit applications; reviewing records to determine the status of claims and applications; responding to inquiries regarding patient eligibility requirements, benefits, and program guidelines; and maintaining accurate patient records through data entry, discrepancy resolution, and follow-up on pending claims and missing documentation.

GS-07:
Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least 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: determining patient eligibility and preparing or issuing medical authorizations and denial determinations in accordance with established regulations and program requirements; identifying and verifying alternate resource coverage, including Medicare, Medicaid, VA benefits, and private insurance;researching and resolving discrepancies related to eligibility, claims, medical authorizations, coverage, and supporting documentation; coordinating referrals and follow-up with healthcare facilities to support continuity of care; and responding to inquiries from patients, providers, and agencies regarding eligibility, claims, and program requirements.

GS-08:
Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least 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: applying and interpreting complex federal, state, Tribal, and private-sector regulations to make eligibility and funding determinations for programs such as Purchased/Referred Care, Medicare, Medicaid, Veterans Affairs healthcare, and Affordable Care Act plans; independently analyzing medical,financial, and eligibility documentation to resolve complex or controversial benefit issues; coordinating with agencies, providers, and patients to ensure fiscal accountability and continuity of care; issuing medical authorizations or denial determinations based on regulatory, clinical, and fiscal requirements; maintaining fund control records, monitoring expenditures, and applying appropriate accounting codes; identifying and resolving program or funding discrepancies; and compiling and analyzing reports related to program operations, funding, and utilization.

Time In Grade
Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP).

You must meet all qualification requirements within 30 days of the closing date of the announcement.

Education

There are no education requirements.

Additional information

IHS Selectees whose duties and responsibilities require them to work permanently, temporarily, or occasionally in an IHS healthcare facility must comply with the IHS Employee Immunization Policy related to vaccine-preventable diseases, consistent with recommendations for healthcare workers. Vaccine exemption requests may be available, as outlined in the IHS Employee Immunization Policy and facility guidance.

Reasonable Accommodation (RA) Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments if you received the link after the close of the announcement. To determine if you need a RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments. (https://appsupport-usastaffing.opm.gov/hc/en-us/sections/45063131363475-Reasonable-Accommodation-Information)


This position is covered by a Bargaining Unit.



This position has promotion potential to the GS-GS-8 grade level. Promotion to the next grade level is at management's discretion and is based on your demonstrated ability to perform the higher level duties, the continuing need for the higher level duties, and "Regulatory/Administrative" approval. Promotion to the next higher grade level is not guaranteed and no promise of promotion is implied.

You will be evaluated for this position in accordance with the OPM Merit Hiring Plan.
As part of the application process, you will be asked to provide short essay responses (200 words or less each) to the following four questions.

  1. How has your commitment to the Constitution and the founding principles of the United States inspired you to pursue this role within the Federal government?
  2. In this role, how would you use your skills and experience to improve government efficiency and effectiveness?
  3. How would you help advance the President's Executive Orders and policy priorities in this role?
  4. How has a strong work ethic contributed to your professional, academic or personal achievements?
  • Your responses are optional and will not be scored.
  • However, they may be reviewed by hiring managers and agency leadership (or designees) during the evaluation process.
  • You will be asked to certify that your responses are written in your own words and that you did not use a consultant or artificial intelligence (AI) tool (such as ChatGPT or Copilot).

Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.

How you will be evaluated

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

This job announcement uses the USA Hire Assessment to evaluate applicants. There is no "pass/fail" outcome; results are used as part of the overall evaluation process to determine applicant qualifications. However, if you do not take the assessment within the assessment window timeframe you will be found ineligible for this position. For more information, visit the USA Hire Applicant Resource Center.

You will be evaluated based on how well you meet the qualifications listed in this vacancy announcement. Your qualifications will be evaluated based on your application materials (e.g., resume, supporting documents), your responses on the application questionnaire, and your responses to all assessments required for this position.

You will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics):

  • Accountability
  • Attention to Detail
  • Customer Service
  • Decision Making
  • Flexibility
  • Influencing/Negotiating
  • Integrity/Honesty
  • Interpersonal Skills
  • Learning
  • Reading Comprehension
  • Reasoning
  • Self-Management
  • Stress Tolerance
  • Teamwork

Overstating your qualifications and/or experience in your application materials or application questionnaire may result in your removal from consideration. Cheating on an assessment may also result in your removal from consideration.

To preview the application questionnaire, click the following link: https://apply.usastaffing.gov/ViewQuestionnaire/13042789

Once the application process is complete, the first two pages of your resume and supporting documentation will be used to determine whether you meet the job qualifications.

All documents above MUST be received by 11:59 pm (Eastern Standard Time) of the closing date of 09/14/2026, to be considered.

Indian Health Service

Become a part of an innovative, dynamic, nationwide organization of dedicated health care providers working to meet the individual health care needs of American Indians and Alaska Natives. Indian Health Service (IHS) employees are considerate in our care, creative in our approach, enthusiastic about our work and compassionate with our patients. Our lifestyle is adventurous, community oriented and focused on service and problem solving as part of a professional interdisciplinary team. Join us in improving the health outcomes of over 2 million American Indians and Alaska Natives.

As part of our team, you will collaborate with dedicated professionals to champion health equity and build a healthier, stronger future for the tribal community we serve.

This position is located in the Purchased/Referred Care at an IHS Service Unit. The purpose of the position is to administer the provision of Purchased/Referred Care in compliance with regulatory requirements set forth in the 42 CFR, Subpart 136, to determine patient's eligibility, defining and interpreting PRC regulations and guidelines and maintaining records. Employee identifies and assists patients who may be eligible for coverage by third party resources. Subject matter expert in determining patient's PRC eligibility and advise others as needed.

Agency contact information

David Groves
Phone
615-596-4225
Email
David.Groves@ihs.gov
Address
Cheyenne River Service Unit
24276 166th Street
Airport Road
Eagle Butte, SD 57625
US

Visit our careers page

Learn more about what it's like to work at Indian Health Service, what the agency does, and about the types of careers this agency offers.

http://www.ihs.gov

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