Medical Management Specialist

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 12/03/2024. Time-In-Grade Requirement: Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. For a GS 9 position you must have served 52 weeks at the GS7. For a GS-11 position you must have served 52 weeks at the GS-09. The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade. ote: Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment. You may qualify based on your experience and/or education as described below: GS-09 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-07 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Knowledge and experience in the field of health care administration and delivery systems for the provision and execution of outpatient care; Knowledge of VA regulations and laws governing VA medical benefits and of care and the overall programs related to the health care delivery system; the Privacy Act; Joint Commission Standards, Health Insurance Portability and Accountability Act (HIPAA), state and federal laws; Knowledge of the substantive programs and organizational structure of the VAMC to gather information, analyze data and develop and write detailed reports; Knowledge of basic principles and practices of the Business Office in conducting budget and financial management, file, database and records management, coordination of activities and communication that supports service operations, coordination and tracking of human resources actions, procurement and contracting, statistical and other administrative functions; Experience in applying analytical and evaluative methods and techniques to issues or studies concerning the efficiency and effectiveness of program operations; Knowledge and experience in the field of outpatient administration, benefits and eligibility, medical records, and related fields of medical administration; Ability to deal with a variety of individuals with tact and diplomacy. OR, Education: Applicants may substitute education for the experience required for the GS-09 level. Master’s or equivalent graduate degree, or 2 full years of progressively higher level graduate education leading to such a degree, or LL.B, or J.D., if related. Education must have been obtained in an accredited college or university and must demonstrate the knowledge, skills, and abilities necessary to do the work of this position. NOTE: Transcripts must be submitted. Education cannot be credited without documentation (TRANSCRIPTS REQUIRED) OR Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond one year of graduate education. (TRANSCRIPTS REQUIRED). GS-11 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-09 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Broad knowledge and experience in the field of health care administration and delivery systems for the provision and execution of outpatient care. Extensive knowledge of VA regulations and laws governing VA medical benefits and of care and the overall programs related to the health care delivery system; the Privacy Act; Joint Commission Standards, Health Insurance Portability and Accountability Act (HIPAA), state and federal laws. In-depth knowledge of the substantive programs and organizational structure of the VAMC to gather information, analyze data and develop and write detailed reports. Knowledge of medical eligibility and public law pertaining to health care for Veterans, billing for medical services provided, state and local laws for billing activity. Knowledge, sufficient to manage and lead staff who routinely support registrations, scheduling, coding, revenue, transportation, and scanning including but not limited to VISTA, VS GUI (VSE), Insurance Capture Buffer (ICB), Patient Check-In (PCI), Enrollment System (ES), Veteran Benefits Management System (VBMS), and ROI-Plus. Knowledge and skill in applying analytical and evaluative methods and techniques to issues or studies concerning the efficiency and effectiveness of program operations. Broad knowledge and experience in the field of outpatient administration, benefits and eligibility, medical records, and related fields of medical administration. Develop and apply financial management techniques and methodologies to plan, execute, and review programs within the Business Office. Ability to deal with a variety of individuals with tact and diplomacy. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have Ph.D. or equivalent doctoral degree or 3 full years of progressively higher-level graduate education leading to such a degree or LL.M., if related. (TRANSCRIPTS REQUIRED). OR, Combination: Applicants may also combine education and experience to qualify at this level. You must possess equivalent combinations of successfully completed graduate level education (in excess of the first two years or 36 semester hours) and specialized experience to meet total experience requirements. NOTE: Transcripts must be submitted. Education cannot be credited without documentation (TRANSCRIPTS REQUIRED). You will be rated on the following Competencies for this position: Administration and Management Organizational Performance Analysis Planning and Evaluating Quality Assurance Physical Requirements: Regular and recurring work is mostly sedentary involving sitting at a desk, although the position requires the ability to move from one geographic location of the facility to another. The incumbent works with a computer screen and keyboard. Some physical effort such as standing, walking, bending or prolonged sitting may be required. The incumbent may be exposed to walking to outlying areas. The work places no special physical demands on the employee. For more information on these qualification standards, please visit the United States Office of Personnel Management’s website at https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/.
The Lexington VA Health Care System (LVAHCS) is a 1b complexity tertiary care VA healthcare system located in Lexington, KY of the United States. The facility provides comprehensive services with a 92 bed complement at the Bowling Campus as well as a 50 bed Community Living Center and an additional 30 bed Psychosocial Residential Rehabilitation beds at Sousley Campus.