Health System Specialist (CHEF Manager)

Job Description

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. BASIC REQUIREMENT(S): Major study - hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. OR Specialized Experience: Progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care field. This work may have been performed in an operating health care facility or a higher organizational echelon with advisory or directional authority over such facilities. Work must have involved a close working relationship with facility managers and analysis and/or coordination of administrative, clinical, or other service activities, and provided knowledge of the following: Missions, organizations, programs, and requirements of health care delivery systems; Regulations and standards of various regulatory and credentialing groups; and Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement. Special Provision for Inservice Placement: Successful completion of an agency-sponsored on-the-job training program may be substituted for qualifying experience, provided it included a formal individualized training plan. Such a training program must have been conducted in an operating health care system and included: Assignments providing a knowledge of basic health system administration philosophies, practices, and procedures, and basic government administrative policies and requirements; Practical assignments providing an opportunity to apply health system administration skills and principles (as the individual progresses, work assignments must be characteristic of the grade level to which he or she is assigned); and Oversight by an experienced health system administrator with periodic evaluation of the individual's progress and appropriate adjustment of the training program. In addition to the Basic Requirements, you must also meet the Minimum Qualifications stated below. MINIMUM QUALIFICATIONS: GS-13 Specialized Experience: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-12 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: administering and evaluating health care programs; analyzing Purchased/Referred Care (PRC) program operations, funding, reimbursement activities, and applicable policies and procedures; reviewing complex health care reimbursement cases to determine compliance with PRC and Catastrophic Health Emergency Fund (CHEF) established requirements; providing technical assistance and guidance to program officials and stakeholders; and developing recommendations to resolve operational problems and improve PRC and CHEF program effectiveness. GS-14 Specialized Experience: One year of specialized experience equivalent to at least the GS-13 grade level in the Federal service. Specialized experience includes administering and evaluating health care reimbursement programs and analyzing complex Purchased/Referred Care (PRC) programmatic, operational, financial, and reimbursement issues. Experience includes reviewing and adjudicating PRC and Catastrophic Health Emergency Fund (CHEF) reimbursement cases; interpreting and applying program policies, regulations, and procedures; and providing technical guidance and assistance to program officials and stakeholders. Experience also includes analyzing CHEF program and financial data, identifying operational deficiencies or systemic issues, and developing recommendations, guidance, or procedural improvements to support effective PRC and CHEF program administration. 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.