Program Specialist
What you'd do
The Northern Arizona VA Health Care System is currently recruiting for one Program Specialist (Patient Representative) in the Community Care Service, Prescott, Arizona. The incumbent conducts reviews in the areas of community care coordination and payment of claims related to care in the community with the Budget Analyst to attempt and resolve concerns from Veterans and community providers
Major duties
The incumbent conducts reviews as required by their direct supervisor and medical center leadership. Other duties include, but are not limited to, the following: Contact members of the hospital staff at all levels concerning patient care issues not been resolved by other services and seeks resolution utilizing the full resources of the medical center and VA system. Explore all avenues, crossing lines of authority and responsibility within the medical center, to identify the nature and scope of the problem and to initiate appropriate action for resolution. Independently resolves the most difficult, complex, and sensitive care issues and system-related problems, applying advanced judgement across multiple program areas and organizational levels. Gather, analyze, and prepares information using sound judgement in response to inquiries, including Congressional Offices, White House Hotlines, Advance Credit Reports (ACR), VAIQs, Exec VA, CBI Helpline, Call Center Portals, and Reports of Contact while managing relationships across business units. Reviews files and records, and discusses with personnel or witnesses regarding any practice that appears to violate patient's rights or which causes unnecessary discomfort or embarrassment to patients, their families, or the health care facility and reports such findings with recommendations for improvements to the facility Director and/or top management team. Ensure national VA patient advocacy program requirements are met by collecting, analyzing, and evaluating relevant data, and preparing meaningful reports based on that data. - Evaluates the effectiveness, efficiency, and compliance of Community Care operations and related processes, and develops data-driven recommendations for improvement. Applies analytical and evaluative methods to assess program performance, identify trends, and recommend enhancements to improve service delivery and patient outcomes. Serve as an advocate for patients throughout Community Care Service, receiving and addressing complaints and grievances from patients or their representatives. Provides explanation regarding Veteran eligibility/entitlement to benefits according to the Veterans' Benefit Package and the laws and regulations governing VA authority to authorize payment for care in the community. Communicate with the Veteran to assist in filing claims and explain what action is needed by the Veteran to support their claims. Receives telephone calls regarding denied or rejected claims and coordinates with appropriate personnel when additional information is required for further review. Provides consultative guidance to leadership, staff, and stakeholders regarding patient advocacy issues, program operations, and regulatory requirements. Interprets and applies Federal laws, VA regulations, policies, and procedures to ensure compliance with the Mission Act and other governing authorities. Coordinates and reroutes calls appropriately with multiples departments are involved. Facilitates and follows through to ensure final resolution to the customer. Performs all other duties as assigned. Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level. Work Schedule: Monday through Friday, 8:00am to 4:30pm (Tour may be subject to change based on needs of the facility). Telework: Not Authorized Virtual: This is not a virtual position. Compressed/Flexible: Not Authorized Position Description/PD#: Program Specialist/PD132990 Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required
What you need to qualify
To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 07/06/2026. 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. 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. 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. You may qualify based on your experience and/or education as described below: 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. Qualifying specialized experience includes providing customer service to patients; assisting patients and staff with resolving problems or complaints; assisting with identifying problem areas and suggesting solutions or alternatives; explaining policies and procedures; keeping accurate records and preparing reports and/or written correspondence. NOTE: Experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. OR, Education: Successfully completed two (2) years of progressively higher-level graduate education or masters or equivalent graduate degree or LL.B. or J.D., in a related field of the position to be filled. Education at the graduate level 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 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 experience requirements. The education portion must include graduate courses that demonstrate the knowledge, skills, and abilities necessary to do to the work of this position. This education must have been obtained in an accredited college or university. NOTE: Transcripts must be submitted with your application materials. Education cannot be credited without documentation. Experience must be clearly indicated in your resume. 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. Qualifying specialized experience includes providing customer service to patients and staff with resolving problems or complaints; identifying problem areas and suggesting solutions or alternatives; explaining policies and procedures; keeping accurate records and preparing reports and/or written correspondence; collaborating with facility staff to improve the patient experience. NOTE: Experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. OR, Education: Successfully completed three (3) years of progressively higher-level graduate education leading to a Ph.D. degree, or Ph.D., or equivalent doctoral degree in the related field of the position to be filled. The education portion must include courses that 4/30/2026 10:13 EDT Page 4 of 7 demonstrate the knowledge, skills, and abilities necessary to do the work of this position. Education must have been obtained in an accredited college, or university. NOTE: 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 2 years) and specialized experience as described above to meet total experience requirements. The education portion must include graduate courses that demonstrate the knowledge, skills, and abilities necessary to do to the work of this position. NOTE: Transcripts must be submitted with your application materials. Education cannot be credited without documentation. Experience must be clearly indicated in your resume. Preferred Experience : Experience and knowledge in Community Care programs, including systems used for consultation management such as RefDoc, HSRM, and EPS. 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/.
Before you apply
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