Health Systems Specialist (Complicance Officer)
What you'd do
The Prescott Health Care System is currently recruiting one Health System Specialist (Compliance Officer) in the Director's Office in Prescott, Arizona. The incumbent is to provide support to health care management officials by analyzing, evaluating, advising on and/or coordinating health care delivery systems and operations. The positions renders advice on operational policies and assures these policies and assures these policies are coordinated with, and in support of, field operations.
Major duties
Duties include but are not limited to the following: Maintain helpline process to receive complaints, and the adoption of procedures to protect the anonymity of complainants. Handle conflict and problems in dealing with the customer constructively and/or appropriately. Maintain high visibility and an open-door policy to encourage employees to report potential compliance issues. Provide guidance and counsel on incorporating compliance-related activities into operations areas. Manage and coordinate online communication tools e.g. assigned intranet, websites, internal SharePoint website collection, and other related informational tools in consultation with communication specialists. Assure compliance with all applicable policies, development and maintenance of internal management processes related to online tools. Analyze audit results, develop educational tools to address audit findings, and recommend system changes as appropriate. Perform an annual system wide prioritized risk assessment, develop and/or provide effective education and training programs for all affected employees to mitigate identified risks. Establish and maintain effective relationships with and gain the cooperation of supervisors, managers, and co-workers on complex or controversial issues. Develop long-range program plans, goals, objectives, and milestones or evaluates the effectiveness of programs conducted throughout an agency, or a regional structure of equivalent scope. Promote a culture of safety and eradicate potential events including the reporting of events resulting in actual or potential injury to a patient. Review periodic reports with senior management detailing compliance initiatives throughout the year and recommends changes and improvements programs and operational compliance related activities. Conduct investigation and remediation of system problems identified through the helpline, employee/patient communications, and/or interaction with professional counterparts. Identify and develop ways to resolve problems or cope with issues which directly affect the accomplishment of principal program goals and/or objectives. Develop new ways to resolve major administrative problems and plans the most significant administrative management aspects of professional or scientific programs. Respond and take appropriate action to allegations of improper/illegal activities and regulations, or federal health care program requirements. Monitor and manage incoming actions and requests from initial receipt to completion and closeout. Distribute written policies and procedures that promote commitment to compliance and address specific areas of potential fraud, such as billing, collections, and coding. Develop, coordinate and conduct audits and/or other evaluation techniques to monitor compliance and to assist in the reduction of identified problem areas. Develop new ways to resolve major administrative problems or plans the most significant administrative management aspects of professional or scientific programs. Work Schedule: Monday - Friday, 8:00 am - 4:30 pm. Position Description/PD#: Health Systems Specialist (Complicance Officer)/PD12957A Relocation/Recruitment Incentives: May be authorized for highly qualified applicants.
What you need to qualify
To qualify for this position, applicants must meet all requirements by the closing date of this announcement. INDIVIDUAL OCCUPATIONAL REQUIREMENT (IOR): An IOR is a basic requirement that must be met in order to qualify for entry into this job series, and it is something that can't be waived. The education must be accredited by an accrediting body recognized by the U.S. Department of Education at the time the degree was obtained. To qualify for the GS 0671 occupational series, applicants MUST possess one of the following: UNDERGRADUATE AND GRADUATE EDUCATION: 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. (A transcript must be submitted with your application if you are basing your qualifications on education). OR, SPECIALIZED EXPERIENCE: specialized experience that is progressively responsible for analytical or administrative, or clinical management, or supervisory experience in the health care field performed in an operating health care facility or a higher organizational echelon with advisory or directional authority over such facilities with close working relationships with facility managers and analysis/coordination of administrative, clinical, or other service activities which provided knowledge in the following areas: 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, SPECIAL PROVISION FOR INSERVICE PLACEMENT: Completion of an agency-sponsored on-the-job training program, which included a formal individualized training plan. The training program should have been performed in an operating health care system and included: 1) Assignments providing a knowledge of basic health system administration philosophies, practices, and procedures, and basic government administrative policies and requirements; 2) 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 3) Oversight by an experienced health system administrator with periodic evaluation of the individual's progress and appropriate adjustment of the training program. In addition to meeting the IOR, you may qualify based on your specialized experience as described below: 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-13 position you must have served 52 weeks at the GS-12 level. 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 as described below: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-12 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: 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. 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: No special physical demands such as above average ability, dexterity, or strength are required to perform the work. Work is sedentary, and the employee may sit comfortably. There may be some walking, standing, bending, carrying of light items, driving of an automobile, etc. Fieldwork may involve traveling to other facility sites of care, interviews, meetings, and sources of information. 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/.
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