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

Health System Specialist - Credentialing and Privileging Specialist

VETERANS HEALTH ADMINISTRATION • Saginaw, MI, United States
23 hours ago
Job type
  • Full-time
  • Part-time
  • Permanent
Job description

Summary

The Medical Staff Office 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 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
  • 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

    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 / 08 / 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-09 position you must have served 52 weeks at the GS-07. 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. Note : 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.

    To qualify for this position at the GS-9 level, you must meet one of the following :

    Specialized Experience : You must have at least one (1) full year of specialized experience, equivalent to the next lower grade level (GS-7) in Federal Service, that equipped you with the particular knowledge, skills, and abilities to successfully perform the duties of a Health System Specialist - Credentialing and Privileging, and includes performing duties associated with healthcare credentialing and privileging. Qualifying specialized experience is defined as 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 : (1) Missions, organizations, programs, and requirements of health care delivery systems; (2) Regulations and standards of various regulatory and credentialing groups; and (3) Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement.

    ~OR~

    Education : Successful completion of a master's or equivalent graduate degree, successfully completed two (2) full years of progressively higher level graduate education leading to such a degree, LL.B or J.D. if related. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work of this position (i.e., hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration). NOTE : Copies of transcripts must be submitted with your application materials. Education cannot be credited without documentation.

    ~OR~

    Combination : Combinations of successfully completed graduate level education (beyond the first year) and specialized experience, as described above, to meet the total requirements. The education portion must include graduate courses that demonstrate the knowledge, skills, and abilities necessary to do to the work of this position (i.e. hospital administration, public health administration, or related fields such as course work in health care administration). NOTE : Copies of transcripts must be submitted with your application materials. Education cannot be credited without documentation.

    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 : Combination : Combinations of successfully completed graduate level education (beyond the first year) and specialized experience, as described above, to meet the total requirements. The education portion must include graduate courses that demonstrate the knowledge, skills, and abilities necessary to do to the work of this position (i.e. hospital administration, public health administration, or related fields such as course work in health care administration). NOTE : Copies of transcripts must be submitted with your application materials. Education cannot be credited without documentation.

    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 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 :

    Additional information

    Receiving Service Credit or Earning Annual (Vacation) Leave : Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed.

    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.

    Smoke-free Facility : All Department of Veterans Affairs facilities are smoke-free. Patients, visitors, and employees are not allowed to smoke in or near any facilities or on the grounds.

    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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    Credentialing Specialist • Saginaw, MI, United States

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