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Health System Specialist - Credentialing and Privileging Specialist
Health System Specialist - Credentialing and Privileging SpecialistVETERANS HEALTH ADMINISTRATION • Detroit, MI, United States
Health System Specialist - Credentialing and Privileging Specialist

Health System Specialist - Credentialing and Privileging Specialist

VETERANS HEALTH ADMINISTRATION • Detroit, MI, United States
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Summary

The John D. Dingell VA Medical Center is recruiting for a Health System Specialist - Credentialing and Privileging Specialist for the The Medical Staff Office. Incumbent is responsible for the Credentialing and Privileging (C&P) process of VAMC clinical services providers, including full-time, part-time, temporary, intermittent, contract, without compensation (WOC), fee basis, and telehealth Licensed Independent Providers (LIPs), as defined in the VAMC Medical Staff Bylaws.

Duties

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Duties include, but are not limited to :

Program Analysis and Support - 25%

  • 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 C&P Manager / Analyst in drafting local credentialing processes and Medical Staff Bylaws in compliance with all applicable regulations
  • The incumbent ensures accurate provider data is entered into and maintained in the VetPro computer program.
  • The incumbent holds the credit card and is responsible for maintaining records, reconciling monthly charge statements and verifying legitimacy of requests for National Practitioner Data Bank - Continuous Query (NPDB-CQ) enrollments / renewals, licensure verification (if applicable), Educational Commission for Foreign Medical Graduates, American Medical Association, Federation of State Medical Boards (FSMB), National Student Clearing House, Work Number and, board certification (if applicable).

Compliance - 25%

  • Manages provider applications (initial and renewals) for Licensed Independent Practitioners (LIPs) C&P within the Medical Center.
  • Provides guidance and instruction to hospital staff in completing the required documentation for establishing privileges for LIPs
  • Quality Assurance - 25%

  • Ensures that application packages and other documents meet the technical requirements specific to the provider's specialty and verifies that the application folder and database account (VetPro or other internal databases and spreadsheets) comply with these requirements.
  • Communicates with LIPs to assure timely completion of applications and VetPro requirements
  • Coordinates incoming data from a variety of sources; establishes protocols for incoming data; organizes computerized data sets; and retrieves computerized data
  • Participates in the required annual C&P self-assessment and, if opportunities for improvement are identified, is involved in efforts to implement these improvements.
  • Program Advisor - 25%

  • Serves as technical advisor to the Executive Committee of the Medical Staff (ECMS) and, if applicable, the Credentials Committee
  • Refers to current issues, trends, problem areas, as well as recommended program revisions to Credentials and Privileging functions through the C&P Manager / Analyst.
  • Prepares agendas for credential-related meetings, ensures those involved are notified of expectations, and ensures that all necessary paperwork is completed and accurately prepared for committee action
  • Conducts final appointment into the VetPro database, after thoroughly researching, analyzing, and validating all data, information, documents, and signature authorities
  • Develops and provides routine and special reports as requested by the C&P Manager / Analyst. Composes correspondence requiring Clinical Service Chiefs, Chief of Staff, and Medical Center Director signatures for privileging actions
  • NOTE : The position is under Classification Consistency Review and the grade may change once the person is hired into the role.

    Work Schedule : Monday - Friday, 8 : 00am-4 : 30pm

    Telework : This position may be authorized for as needed (Ad-Hoc) telework. Telework eligibility will be discussed during the interview process.

    Virtual : This is not a virtual position.

    Position Description / PD# : Health System Specialist - Credentialing and Privileging Specialist / PD91698VS

    Relocation / Recruitment Incentives : Not Authorized

    Critical Skills Incentive (CSI) : Not Approved

    Permanent Change of Station (PCS) : Not Authorized

    Requirements

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    Conditions of employment

  • You must be a U.S. Citizen to apply for this job
  • Selective Service Registration is required for males born after 12 / 31 / 1959
  • Subject to background / security investigation
  • Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (). Effective May 7, 2025, driver's licenses or state-issued dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
  • Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP)
  • As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period or 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider :

  • your performance and conduct;
  • the needs and interests of the agency;
  • whether your continued employment would advance organizational goals of the agency or the Government; and
  • whether your continued employment would advance the efficiency of the Federal service.
  • Upon completion of your probationary period or trial period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.

    Qualifications

    To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 12 / 12 / 2025.

    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 GS-7. 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.

    Individual Occupational Requirement (IOR) : This occupational series has an Individual Occupational Requirement (IOR). To meet the IOR / basic qualification of the 0671 Health System Administration Occupational Series, you must possess one of the following :

  • Possess an undergraduate or graduate level degree with a 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,
  • Possess 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; OR,
  • Completed an agency-sponsored on-the-job training program that was a formal individualized training plan within a 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.
  • Proof of successful completion of an agency-sponsored on-the-job training program is required.
  • In addition to meeting the Individual Occupational Requirement (IOR), you may qualify based on your experience and / or education as described below :

  • Specialized Experience : You must have at least one year of specialized experience equivalent to the GS-07 level in the Federal service. Examples of specialized experience would be experience that provided you with the particular knowledge, skills, and abilities to successfully perform the duties of the position and which is typically related to the work of the position to be filled. Examples of specialized experience include, but is not limited to : knowledge and understanding of joint commission standards related to credentialing and privileging; evaluating and explaining policy and handbooks related to healthcare standards; advising providers and management on required documentation for credentialing and privileging; tracking compliance for healthcare standards; reviewing credentialing and privileging documentation for accuracy and compliance; compiling and reviewing data for discrepancies; managing special projects; analyzing reports to ensure they meet standards.
  • OR,

  • Education : Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a masters or equivalent graduate degree or 2 full years of progressively higher-level graduate education leading to such a degree, OR, a related LL.M or J.D to the work of the position. Transcripts must be provided. 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 (1) year of graduate education. To calculate, first identify the percentage of required education you have earned (when substituting, you cannot use the first year of graduate education). Then identify the percentage of required experience you possess. Add the two percentages. The total percentage must equal at least 100 percent to qualify. Transcripts must be provided.
  • You will be rated on the following Competencies for this position :

  • Compliance
  • Technical Competence
  • Quality Assurance
  • Communications
  • NOTE : The position is under Classification Consistency Review and the grade may change once the person is hired into the role.

    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.

    Note : A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment.

    Physical Requirements : The work is mostly sedentary. Occasionally, light physical effort may be required, such as that involved with walking, stair climbing, and carrying of light office items.

    For more information on these qualification standards, please visit the United States Office of Personnel Management's website at

    Education

    A transcript must be submitted with your application if you are basing all or part of your qualifications (to include both the Individual Occupational Requirement (IOR) and / or grade level qualifications) on education.

    Note : Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here : If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit :

    Transcripts must be official or unofficial college transcripts. A copy of your certificate / degree or screenshot of your current classes are not a replacement of your transcript and they will not be used in the qualifying process. Transcripts must include the following information :

  • Your Name
  • Name of the college or university
  • Full address of the college or university
  • Degree Received
  • Date Conferred
  • If the position has an education requirement or you are qualifying based on education, you need to list your education history including the type of degree and your major of study. If the position requires a certain number of credit hours, you are strongly encouraged to list the relevant courses in your resume.

    Additional information

    This job opportunity announcement may be used to fill additional vacancies.

    If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement.

    Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration / Operations, Security, and Preparedness (HRA / OSP) at The Fair Chance Act.

    VA Healthcare System Serving Ohio, Indiana and Michigan (VISN 10) advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care, you will operate in a model with three core elements, seeking to create a personalized health plan for each Veteran. This is done in the context of healing relationships and healing environments and a connection back to the Veteran's community. This aligns with the Veterans Health Administration (VHA) Mission Statement to Honor America's Veterans by providing exceptional health care that improves their health and well-being.

    Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.

    Help

    A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.

    Review our benefits

    Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.

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