Vacancy expired!
SummaryThis position is located at the VA Pacific Islands Health Care in the Consult Management Section of the Managed Care Service. The incumbent is the point of contact for all Non VA fee basis healthcare services, serving as the liaison between the veteran and the vendor, and working with clinical and administrative staff to determine the specific eligible services to be provided.ResponsibilitiesMajor Duties Include: Eligibility verification for fee basis (non-VA Care services). Data entry according to protocol and SOPs. Prepares authorizations and ensures proper documents accompany patient to the provider. Resolves matters of delay in processing Veterans with TAMC or Fee Basis appointments Prepares denial letters and forwards to Veterans and providers if Fee Basis request is denied. Obtains and maintains access to necessary electronic medical records for both VA and DoD. Weekly/monthly monitoring active/scheduled consults. Receives incoming calls and personal contacts from patients, families, VA practitioners and private sector vendors. Processes incoming reports of recommendations from outside physicians and forwards to appropriate VA practitioner. Work Schedule: Monday - Friday; 7:30am to 4:00pm.Virtual: This is a Virtual PositionPosition Description Title/PD#: Program Support Assistant/ Physical Requirements: Work is primarily sedentary. Work will involve some walking (between different offices, and to/from different areas of the Service), standing, bending, and lifting of light objects (such as books, files, papers, etc.), as well as a good deal of work on a computer keyboard.RequirementsConditions of EmploymentQualificationsTo qualify for this position, applicants must meet all requirements by the closing date of this announcement. GS-6 grade level: One year of specialized experience (equivalent to the GS-6 grade level in the federal service); experience that equipped the applicant with the particular knowledge, skills and abilities (KSA's) and other characteristics to perform successfully the duties of the position, and that is typically in or related to the work of the position to be filled, in the normal line of progression for the occupation in the organization. Specialized experience is experience in: extensive and detailed knowledge of agency procedures, policies, directives and processes associated with clerical development of the most difficult cases. Also required is the knowledge of an extensive body of regulations, rules, procedures, and practices to examine a variety of types of authorizations relevant to Fee Basis/Non VA Care consult processing; maintain all necessary access to electronic medical records as identified by his/her supervisor; knowledge of Fee/Non VA Care Consult authorizations and procedures is required in order to provide answers to general inquiries; interpersonal communication skills is required, including the ability to handle irate clients and answer complex eligibility questions; To calculate, first identify the percentage of required education you have earned (when substituting, you cannot use the first 60 semester hours that you earned). Then identify the percentage of required experience you possess. Add the two percentages. The total percentage must equal at least 100 percent to qualify at the GS-6. For example, an applicant who has 9 semester hours of graduate level education (i.e. 50% of graduate education required) and 6 months of creditable specialized experience (i.e. 50% of the required experience) would equal 100% of the required experience for the position A transcript must be submitted with your application if you are basing all or part of your qualifications on education. There is no educational substitution for the GS-6 level. 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.EducationAdditional InformationVA supports the use of telework as a way to help attract and retain talented individuals in public service, increase worker productivity, and better prepare the agency to operate during emergencies. This position may be authorized for telework. Telework eligibility will be discussed during the interview process. The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced VA competitive service employees with selection priority over other candidates for competitive service vacancies. To be well-qualified, applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors if applicable, and must be proficient in most of the requirements of the job. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website which can be found at https://www.opm.gov/. Receiving Service Credit for Earning Annual (Vacation) Leave: 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. VA may offer newly-appointed Federal employee's credit for their job-related 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. Such credit must be requested and approved prior to the appointment date and is not guaranteed. This job opportunity announcement may be used to fill additional vacancies. If you are unable to apply online view the following link for information regarding an Alternate Application.
