Health System Specialist (Process Improvement)

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): Individual Occupational Requirements Undergraduate and Graduate Education: 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 (for positions above GS-5): 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 complete 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 Individual Occupation Requirements, you must also meet the Minimum Qualifications stated below. MINIMUM QUALIFICATIONS - GS-9: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-07 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Identifying inaccuracies and oversights in areas of patient registration process, determining eligibility and alternate resources, RPMS data intake, documentation collection, patient screening process, and interpreting rules and regulations of the agency and federal and state entities to identify loopholes that lead to denials of claims that are submitted for reimbursement. Develop and implement comprehensive internal quality control system that measures the effectiveness of such controls and their impact on the program. Providing technical assistance and support to program staff on matters involving oversight of patient registration and alternate resources program for a complex health care facility. Experience in training, plan, develop, implement, direct, coordinate, and evaluate Performance Improvement. Communicate and maintain effective working relationship with health professionals. Interpret and apply federal health care system regulations to deal with matters of standard compliance. OR; Master's degree or equivalent degree that included the major study in hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration OR; Completion of two full years of progressively higher-level graduate education leading to such a degree that included major study - hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. OR LL.B. or J.D., if related, that included major study -- hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. OR Possess a combination of education and experience that when combined fully meet the minimum qualifications for this position. The total percentage equals at least 100 percent to qua