Who may be considered:
U.S. Citizens, who are:
Current or former Civil Service employees; OR
PHS Commissioned Officers; OR
American Indians with no prior federal experience; OR
Veterans applying under VEOA
The IHS is the principal federal health care provider and health advocate for American Indians and Alaska Natives (AI/AN). The IHS goal is to raise Indian health status to the highest possible level. IHS provides leadership and direction to programs and activities designed to improve health outcomes to over 1.9 million AI/AN through a system of IHS, Tribal and Urban operated facilities and programs. For information on the IHS visit IHS.GOV .
The Indian Health Service is required by law to give preference to qualified applicants who meet the Secretary of the Interior's definition of Indian for appointment to vacancies within the IHS in accordance with established IHS policy as outlined in the Indian Health Manual Part 7, Chapter 3. The Indian Health Service is an Equal Opportunity Employer.
This position is located in the Division of Business Office Enhancement (DBOE), Office of Resource Access and Partnerships (ORAP), Headquarters (HQ), Indian Health Service (IHS) in Rockville, Maryland. The DBOE focuses on improving business process for revenue generation in the IHS, Tribally Managed Programs and Urban Health Programs (I/T/U). The primary purpose of this position is to provide technical and program support to the various functions of the revenue cycle business process, operations, Resource and Patient Management System (RPMS) information systems, Electronic Medical Records systems, and payer policies that impact third party reimbursement levels. The scope of work is diverse and cuts across all issues that impact I/T/U revenue levels from third party payers, e.g., systems software operational integration, third party payer benefit coverage, payment methodologies, payer Compliance, Federal/State/private managed care initiatives and Business Office process Operations.
The incumbent reports to the Director, DBOE who in turn reports to the Director, ORAP
- The selected applicant will be subject to a pre-employment background
- investigation, which will include a fingerprint check.
· Assessment of the impact of program/operational policies and IT software programs, on third party collections and payment for health care provided in the private sector.
· Provides Liaison and Coordination for Third Party Collections impacting the field business process relating to third party revenue, patient registration, third party billing, coding, Accounts Receivable, etc. Typically, this will require providing operational information to I/T/U staff and/or providing leadership for or serving directly on workgroups established to make recommendations in problem areas. Also responds to congressional inquiries, and provides consultation to Headquarters and Area Offices on such matters.
· Billing Software Analysis, serving as the focal point for problems that require an IHS wide solution or initiative to provide electronic systems and policy guidance to assist Headquarters and field staff with improving business process initiatives. This includes but is not limited to analyses of the impact of 1) IT software system modification and policy changes on IHS business functions/activities and revenue levels; 2) State managed care initiatives and other national regulation and policies that may significantly affect the IHS health care delivery system and the levels of third party revenue from all sources.
· Training and guidance to Area and SU Business Office staff in 12 Areas on monitoring, auditing and sampling tools to meet IHS policies related to third party revenue collections. Provide direction to the Division of Business Office Enhancement on appropriate action to take in third party reimbursement compliance, auditing and quality assurance.
To be considered qualified for this position; applicants must be able to clearly demonstrate in their application, resume and self-assessment questions, specialized experience (below) and competency in the following areas:
- Organizational Awareness
- Technical Competence
- Decision Making
- Interpersonal Skills
- Oral and Written Communication
Specialized Experience Required for this Position:
The basic qualifications for this position are in the Operating Manual for Qualification Standards for General Schedule Positions click on the link below:
You must demonstrate in your resume that you possess the education (if applicable) or one(1) year of specialized experience equivalent to at least the next lower grade level in the federal service obtained in either the private or public sector, performing the following types of tasks:
Specialized experience at the GS-09: Experience in developing routine policies, guidelines, instructions, and procedures for administrative and management requirements. Experience in compiling data and prepares administrative status reports for review at all levels. Assists field staff with improving the business process.
Specialized experience at the GS-11: Experience in reading and analyzing regulations and policy in order to assist senior staff. Provides legal and policy guidance to improve efficiency and productivity in third party billing. Experience with Indian Health programs is needed to determine how changes in regulations and policies impact health care payment and billing programs. Experience in planning and carrying out projects to evaluate program effectiveness.
Specialized experience at the GS-12: Worked in a program that either bills for medical services and/or pays for medical services provided to patients that will enhance the ability to provide technical information to the field programs on revenue collection. Knowledge of Medicare/Medicaid, Children's Health Insurance Program and private insurance is beneficial in order to determine how changes in their regulations and policies impact on health care payment and billing program. Experience with analysis of regulation and policy in order to provide legal and policy guidance to assist staff with improving the business process in third party billing. Experience working with Indian Health care programs is needed in order to determine how changes in regulations and policies impact the health care payment and billing programs.
Specialized experience at the GS-13: Experience and knowledge from working with Medicare/Medicaid, Children's Health Insurance Program and private insurance is needed in order to determine how changes in their regulations and policies impact on health care payment and billing program. Experience with regulation and policy analysis in order to provide legal and policy guidance to assist headquarters and field staff with improving the business process in third party billing. Comprehensive experience and knowledge of Indian Health programs is beneficial in order to determine how changes in regulations and policies impact on health care payment and billing programs.
You must meet the requirements of the job by this date: Friday, March 15, 2013
HOW YOU WILL BE EVALUATED:
Applications will be evaluated to determine whether they document the specialized experience requirements above, by answering questions to document the applicant's competencies. In order to receive credit for qualifying, specialized experience, the applicant's resume MUST support their responses to the assessment questions with clear examples.
The Federal Government offers a comprehensive benefits package. Explore the major benefits offered to most Federal employees at
Alternate work schedules will be considered.
Candidates must meet time-after-competitive appointment, time-in-grade (if applicable), qualification requirements, performance requirements, citizenship and suitability requirements, and any other eligibility requirements within 30 days of the closing date of the vacancy announcement.
Additional or alternate selections may be made within 90 days of the date the candidate referral roster certificate was issued.
· Relocation expenses are not authorized and will not be paid.
If you are claiming CTAP/ICTAP eligibility, you must submit a copy of your most recent performance appraisal, proof of eligibility, and your most current SF-50 noting position, grade level, and duty location. To be considered under CTAP/ICTAP, you must be well qualified with a score of at least 85 for this position. For information on CTAP/ICTAP, visit:
CONDITIONS OF EMPLOYMENT:
Travel will be required 2 to 3 times a year or as necessary.
IHS - Operated Properties are tobacco free
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Indian Health Service's mission is to provide health care and related services for American Indian and Alaska Natives, as well as their...