The position is located in the New Mexico VA Health Care System (NMVAHCS), under the the Office of Integrity and Compliance (OIC) and contributes to the fulfillment of the organizational mission and vision by planning, designing, implementing, and maintaining system-wide compliance programs, policies, and procedures.

Duties

The primary purpose of the position is to provide leadership, strategic direction, and oversight of the compliance activities for the medical facility and to ensure a standardized and effective approach to compliance using the compliance framework, Compliance and Integrity standards, processes, and resources set forth under the Compliance Program national guidelines and associated documents within the VHA health care system and any functions aligned under the VHA health care system. The incumbent develops, implements, and maintains the compliance program throughout the facility. The incumbent Chairs the Facility Compliance Advisory Board. Develops a formal mechanism for documenting and tracking operational area compliance training and monitors this mechanism to ensure the system is used and information is captured timely. Participates in the VISN 22 Compliance Committee to share best practices with other VISN facilities. Reviews, updates, and formulates facility policies and procedures regarding compliance-related activities to ensure consistency among the various divisions and service areas. Interacts with the facility management, government agencies/contractors, Regional Counsel, and employees to ensure an understanding of the organization's initiatives towards compliance and to ensure consistency among the various divisions and service areas. Monitors questions, issues and reports of possible non-compliance reported through established mechanisms. Maintenance of a process, such as a hotline to receive complaints, and the adoption of procedures to protect the anonymity of complainants. Coordination of internal and external compliance reviews. Initiatives investigation, when appropriate, of any issues of non-compliance, as well as the implementation of appropriate corrective action plans. Interacts with the VISN 22 Compliance Officer and management to review the organization's initiatives on regulatory compliance and consistency in application. Reviews periodic reports with the facility management and the VISN 22 Compliance Officer, improvement in the overall compliance program and/or operational compliance related activities. Prepares and submits an annual report to the Director and an annual report to the VISN detailing compliance initiatives as well as recommending improvement/changes in the overall compliance programs. Work Schedule: Monday - Friday, 8:00 AM - 4:30 PM Compressed/Flexible: Supervisor's discretion Telework: VA 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. Virtual: This is not a virtual position. Position Description/PD#: Health System Specialist (Office of Integrity and Compliance)/PD99467S Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement. The Occupational Series 0671 includes an Individual Occupational Requirement (IOR). Candidates may not hold a position in this series without meeting one of the IOR requirements established by OPM. Undergraduate or graduate education in a major field of 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 in 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, Successful completion of an agency-sponsored on-the-job training program, 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. AND, In addition to meeting the IOR, you must also meet the specialized experience as described below: You may qualify based on your experience as described below: Specialized Experience GS-12: You must have one year of specialized experience equivalent to at least the next lower grade GS-11 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Extensive knowledge of Medicare and Medicare rules and regulations, as well as those of Health Care Finance Administration (HCFA). General knowledge of the healthcare industry and/or experience with Medicare and third-party payer coding and billing practices recommended. Knowledge of VHA internal business processes and the revenue cycle. Knowledge of MCCR and all related functional processes such as eligibility, enrollment, means testing, coding, and UR, and billing. Knowledge of VISTA software packages related to these processes, knowledge of VERA model, CDR, FMS, DSS, and other general accounting practices in VHA. Comprehensive knowledge of the VHA healthcare management system including the ability to proactively implement systems that are in concert with the vision and strategic plan of the medical center and VISN. Knowledge and analytical ability enough to conduct comparative studies aimed at determining the effectiveness of a wide range of programs/processes associated with the compliance program. Knowledge of and ability to apply a wide range of principles, theories, and processes of management with a high degree or resourcefulness, ingenuity and inventiveness to a variety of studies, investigations, and assignments. You will be rated on the following Competencies for this position: ComplianceInternal ControlsInternal Controls/Integrity 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 primarily sedentary, although some slight physical effort may be required when visiting different sections of the health care system for meetings or fact-finding. 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/.

Education

There is no educational substitution at this grade level.

A transcript must be submitted with your application if you are basing all or part of your 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: http://ope.ed.gov/accreditation/. 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: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

Contacts

• Address Raymond G Murphy Department of Veterans Affairs Medical Center 1501 San Pedro Drive, Southeast Albuquerque, NM 87108 US
• Name: Kayleigh Lundh
• Phone: 602-757-1832
• Email: [email protected]