Clarification from the agency

This announcement is open to the public. NOTE: The 2-page Resume requirement does not apply to this position. For more information, refer to Required Documents below.

Videos

Total Rewards of a Allied Health Professional

Major duties include:

• Coordinates request for Community Care.
• Screens each fee-for-service request to the Community Care programs.
• Determine patient's eligibility status, technical completeness, accuracy, and urgency of request.
• Serves as primary administrative contact and process expert related to the STVHCS Community Care programs.
• Provides accurate information related to specific Community providers (Location, office contact, etc.), the Community Care process, as well as basic payment and authorization information, etc.
• Schedule appointments, resolve issues, and ensure ongoing patient (and vendor) satisfaction through ongoing customer service activities, problem resolution, and timely response to requests.
• Provides information/education related to the Community Care programs.
• Contacts health care providers in the community to identify additional providers for program referrals.
• Collaborates with the Community care provider, their office staff, and Finance Service to ensure appropriate documentation is received and submitted.
• Collaborates with ordering STVHCS providers, and other clinical staff to expedite and authorize approved Community Care for patients.
• Consults with the requesting provider or Community Care RNs to obtain clarification or additional needed information.
• Collaborates with unit-based Patient Care Coordinators and physicians to facilitate Community Care requests for hospitalized patients.
• Maintains a suspense system.
• Completes daily reviews of active/pending and scheduled consults for accuracy, action, and disposition.
• Authorizes each episode of Community Care through the Heathshare Referral Management (HSRM) software package.
• Determines the appropriate category of care, period of authorization, fund control point, and dollars to be obligated for each request.
• Outlines the authorized services (procedure, exam, test), and approved number of visits.
• Participates in informational presentations to Community Care vendors to outline program requirements, veteran eligibility for service, expected timelines for services and receipt of results, and problem resolution.
• Schedules non-count Community Care appointments using HSRM/Vista scheduling options.
• Oversees release and confidentiality of patient information.
• Receives results and notates receipt on the appropriate consult, scanning results into the patient's record.
• Participates in meetings to identify and resolve issues that impact continuity of care for patients who are receiving Community Care.
• Identifies issues for process improvement and actively participates in service or center-level process improvement activities/teams.
• Orients new service staff to the Community Care programs, serving as a mentor and subject matter expert.
• Utilizes various computer equipment (scanners, double screens), software packages and systems (Vista, Microsoft Office, CPRS, Triwest Portal, HSRM, Refdoc, PPMS) and troubleshoots minor problems.

Work Schedule: Monday - Friday, 7:30 am - 4:00 pm, or 8:00 am - 4:30 pm
Recruitment Incentive (Sign-on Bonus): Not Authorized
Permanent Change of Station (Relocation Assistance): Not Authorized
Pay: Competitive salary and regular salary increases.
Paid Time Off: 37-50 days of annual paid time offer per year (13-26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)
Selected applicants may qualify for credit toward annual leave accrual, based on prior [work experience] or military service experience.
Parental Leave: After 12 months of employment, up to 12 weeks of paid parental leave in connection with the birth, adoption, or foster care placement of a child.
Child Care Subsidy: After 60 days of employment, full time employees with a total family income below $144,000 may be eligible for a childcare subsidy up to 25% of total eligible childcare costs for eligible children up to the monthly maximum of $416.66.
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)
Telework: Not Available
Virtual: This is not a virtual position.
Functional Statement #: 54809-F
Permanent Change of Station (PCS): Not Authorized

Conditions of employment

• You must be a U.S. Citizen to apply for this job.
• Selective Service Registration is required for males born after 12/31/1959.
• Must be proficient in written and spoken English.
• Subject to background/security investigation.
• Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
• Complete all application requirements detailed in the "Required Documents" section of this announcement.

As a condition of employment for accepting this position, you will be required to serve a 1 or 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider:

• your performance and conduct;
• the needs and interests of the agency;
• whether your continued employment would advance organizational goals of the agency or the Government; and
• whether your continued employment would advance the efficiency of the Federal service.

Upon completion of your trial period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.

Qualifications

Basic Requirements:

• United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
• Experience and Education.
  • Experience. Six months experience of clerical, office, customer service, or other administrative work that indicates the ability to acquire the particular knowledge and skills needed to perform the duties of the position; OR,
  • Education. One year above high school; OR,
  • Experience/Education Combination. Equivalent combination of experience and education are qualifying for entry level for which both education and experience are acceptable.
• English Language Proficiency. MSAs must be proficient in spoken and written English in accordance with VA Handbook 5005, Part II, Chapter 3, Section A, paragraph 3.j.

May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria).

Grandfathering Provision: All MSAs employed in VHA in this occupation on the effective date of this qualification standard are considered to have met all qualification requirements for the title, series, and grade held, which are a part of the basic requirements of the occupation. For employees who do not meet all the basic requirements required in this standard, but who met the qualifications applicable to the position at the time they were appointed to it, the following provisions apply:

1. Such employees may be reassigned, promoted, or [changed to a lower grade] within the occupation.
2. Employees who are appointed on a temporary basis prior to the effective date of the qualification standard may not have their temporary appointment extended or be reappointed, on a temporary or permanent basis, until they fully meet the basic requirements of the standard.
3. If an employee who was converted to [Title] 38 hybrid status under this provision leaves the occupation, the employee loses protected status and must meet the full VA qualification standard requirements in effect at the time of reentry to the occupation.

Creditable Experience:

• Knowledge of MSA Practices. To be creditable, the experience must have demonstrated the knowledge, skills, and abilities (KSAs) associated with current MSA responsibilities or an equivalent administrative patient support role in a non-VA medical inpatient or outpatient setting. Experience satisfying this requirement may be paid/non-paid employment as an MSA or an equivalent position in a non-VA hospital or clinic setting.
• Quality of Experience. Qualifying experience must be at a level comparable to MSA experience [or equivalent administrative clinical support role in a non-VA medical inpatient or outpatient setting] at the next lower grade level. For all assignments above the full performance level, the higher-level duties must consist of significant scope, administrative independence, complexity (difficulty), and a range of [varieties] as described in this standard, at the specified grade level and be performed by the incumbent at least 25% of the time.
• Part-Time Experience. Part-time experience as [an MSA or equivalent administrative patient support in] a [non-VA medical inpatient or outpatient setting] is creditable according to its relationship to the full-time workweek. For example, [an] MSA employed 20 hours a week, or on a 1/2-time basis, would receive [one] full-time workweek of credit for each [two] weeks of service.

In addition to the basic requirements for employment listed above, the following criteria must be met to qualify at the GS-06 grade level:

• Experience. One year of experience equivalent to the GS-5 grade level. Examples of experience includes: answering phones; greeting patients; relaying messages to appropriate staff inside or outside of the unit; interpreting and verifying provider orders; scheduling, canceling, re-scheduling patient appointments and/or consults; entering no-show information; monitoring appointment requests from multiple electronic sources; monitoring both inpatient and outpatient appointments; verifying and updating demographics and insurance information during patient check-in; coordinates administrative functions relating to emergency and non-emergency transfers to other facilities; and determines appointment type based on the patient's eligibility status (i.e., TRICARE, sharing agreements, collaterals, research patient, VA employee, etc.).
• Demonstrated Knowledge, Skills, and Abilities. In addition to the experience above, the candidate must demonstrate the following KSAs:
  • Ability to collaborate and communicate with a wide range of medical clinicians across multiple disciplines (e.g. medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical pharmacists, and nursing staff) to accomplish team goal setting to ensure medical care to patients is met.
  • Ability to independently set priorities and organize work to meet deadlines, ensuring compliance with established processes, policies, and regulations.
  • Ability to communicate tactfully and effectively, electronically, by phone, in person, and in writing, with internal and external customers. This may include preparing reports in various formats and presenting data to various organizational levels, as well as resolving patient concerns.
  • Advanced knowledge of the technical health care process (including, but not limited to, scheduling across interdisciplinary coordinated care delivery and/or care in the community models and patient health care portals) as it relates to access to care.
  • Advanced knowledge of policies and procedures associated with interdisciplinary coordinated care delivery and/or care in the community operational activities that affect patient flow, and patient support care [administrative functions] to include, but not limited to appointment cycles, outside patient referrals, follow-up care, overbooking, provider availability, etc.
  • Advanced knowledge of medical terminology due to the technical nature of language utilized by clinicians.

Preferred Experience: Knowledge in Excel.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

Physical Requirements: Work is done in an office setting, mostly sedentary using computers, phones, other office equipment.

How you will be evaluated

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

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Your application, resume, C.V., and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect consideration for employment.

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; religions; 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.

The Department of Veterans Affairs performs pre-employment reference checks as an assessment method used in the hiring process to verify information provided by a candidate (e.g., on resume or during interview or hiring process); gain additional knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position.

It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.

Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members.