Credentialing Program Assistant

To qualify for this position, applicants must meet all requirements by the closing date of this announcement.

GS-06 grade level: One year of specialized experience (equivalent to the GS-05 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 includes: Provides guidance and instruction to hospital staff. Collects, compiles, and tracks data. Communicate in writing to prepare emails, letters and reports. Researches, analyzes and validates all data, information, documents and signature authorities. There is no educational substitution for the GS-06 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.

Duties include, but may not be limited to the following: Credentialing Duties (100%) The incumbent assists the Credentialing and Privileging (C&P) Manager/Analyst in developing short- and long-term goals necessary to accomplish the mission of the C&P program. Assists in identifying the resources necessary for accomplishing the mission and function of the credentials program. Serves as SME in the field of credentials.

Receives and reviews correspondence and communications for the C&P function and determines which items require immediate attention and which are confidential in nature. Receives and reviews VetPro reports detecting problem areas requiring further investigation. Upon identification of a problem, researches reference materials, regulations, and standards to identify appropriate action necessary to correct the problem. Issues of a serious nature are elevated to the supervisor for guidance.

Ensures accurate provider data is entered into and maintained in the VetPro computer program. Ensures current information is present on providers relative to state licensure, Drug Enforcement Organization (DEA) license, National Practitioner Data Bank (NPDB) Continuous Query (CQ) enrollments and renewals, Federation of State Medical Boards (FSMB), documentation of professional education, specialty medical training, certifications, initial credentialing.

Informs C&P Manager/Analyst of trends identified, audit results and identified problems that may affect a provider's credentialing status. Manages provider applications (initial) for non-LIPs within the VAMC. Incumbent must have a general knowledge of medical specialties. Provides guidance and instruction to hospital staff in completing the required documentation of establishing credentialing for non-LIPs.

Upon receipt of individual credentials' files for review, incumbent ensures primary source verification to include, but not limited to, state licenses, DEA license, certifications, medical specialty training, and board certifications. Primary source verification includes, but may not be limited to, the American Medical Association, NPDB, state licensing agencies, specialty certification boards, universities, DoD and healthcare facilities.

Coordinates with clinical service departments on findings of clinical care competency. Participates in the required annual C&P self-assessment and if opportunities for improvement are identified, is involved in improvement efforts. Provides ongoing review of regulatory requirements, TJC Standards, changing laws and legal precedents to review hospital regulations and make necessary recommendations for changes to ensure compliance with current VHA, and, TJC Standards and in the event of an emergency declaration.

• Reviews quality assessment findings, risk management evaluations and malpractice claim actions to ensure appropriate coordination regarding individual provider clinical suitability.
• Performs other duties within the C&P program as assigned.
• Work Schedule: Monday - Friday, 8:00am - 4:30pm Position Description Title/PD#: Credentialing Program Assistant/PD99876S