Health System Specialist

Summary

This position is in the Civilian Health and Medical Program-VA (CHAMPVA), Veteran and Family Member Programs (VFMP) Directorate, Office of Integrated Veteran Care (IVC), Veterans Health Administration (VHA), Department of Veterans Affairs (VA). The position is organizationally aligned under the Chief, CHAMPVA. The primary function of these positions is to provide care coordination support on behalf of beneficiaries enrolled in CHAMPVA Programs.

Duties

The position requires skill in applying analytical and evaluative techniques to the identification, consideration, and resolution of issues or problems of a procedural or factual nature. Recognizes when available data is insufficient to support a conclusion and identifies what additional information is needed. The employee plans, coordinates, and carries out the successive steps in fact-finding and analysis of issues necessary to complete each phase of assigned projects. Anticipates how a proposed change will be received by different audiences and adjusts the framing, sequencing, or content accordingly Builds and sustains comprehensive communication channels via social media and other publicly accessible digital collaboration platforms. Weighs the feasibility of recommendations against resource constraints, staffing realities, and political/organizational dynamics Assists local case management providers and beneficiaries to explain claim processing errors, delays or other problems regarding benefits, pre-authorizations for care and other authorized service activities. Regularly interacts with customers - clinical chiefs, community partners, Veterans' families, VISN program managers - who may be frustrated, skeptical, or adversarial. Effective customer service at this level means de-escalating tension, maintaining professional credibility, and preserving the working relationship even when the interaction is uncomfortable. Facilitates outreach to beneficiaries via email, phone, teleconference or standard letters. Independently provides routine updates to providers and beneficiaries on available services and current policies. Communicates proactively when timelines, outputs, or circumstances change - does not wait for the customer to notice a problem Conducts phone interviews with program beneficiaries, health care providers and other authorized third-party contacts to assist with eligibility issues and healthcare services appropriate to beneficiary needs. Must independently make decisions about how CHAMPVA care coordination programs are structured, how limited resources are allocated across competing program needs, and which program components to prioritize when everything cannot be done simultaneously. Distinguishes between stakeholder input that should change the decision and stakeholder pressure that should not. Must ensure that care coordination programs are not just operationally sound but strategically positioned - aligned with VHA's strategic plan, VISN priorities, facility leadership objectives, and emerging national program emphases Identifies where current care coordination programs are misaligned with emerging organizational priorities and proactively proposes realignment before leadership identifies the gap Work Schedule: Monday through Friday 8:00am to 4:30 pm Compressed/Flexible: Available Telework: This position may be authorized for ad hoc telework. Telework eligibility will be discussed during the interview process. Ad hoc is defined as occasional, non-recurring telework Virtual: This position may be authorized for Virtual Work. Virtual Work eligibility is for current VA employees that are already subject to the return to the in-person work mandate in their current position. Definition of Virtual Work: Employee works outside of original hiring duty station at a VA-owned or leased space. Return to Office (RTO): RTO mandates are in effect and selectees will be required to report to in-person work unless they are approved for an exception or an exemption. Any approval for an RTO exception, exemption, or extension will happen after a tentative job offer, but before a final job offer. Position Description/PD#: Health System Specialist/PD68675A and PD68674A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 10/20/2026. 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 grade 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 and/or education as described below: 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 to qualify for the GS-09. Examples of specialized experience would typically include, but are not limited to: Applying knowledge of health care delivery systems to guide beneficiaries and recommend improvements to program operations. Working effectively with healthcare facilities to interpret program requirements and gather needed technical information. Explaining complex VA policies and regulatory guidelines to diverse beneficiaries and providers OR Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree or LL.B. or J.D., if related. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work. OR, Combination of Education and Experience: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond graduate level education. 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 to qualify for the GS-11. Examples of specialized experience would typically include, but are not limited to: Conducting qualitative and quantitative analyses to evaluate programs and support data-driven improvements. Independently investigating complex issues and delivered clear written and oral recommendations to support VA program decisions. Reviewing and interpreting correspondence and technical documents in order to provide resolutions to customers and stakeholders. OR GS-11 Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a Ph.D. or equivalent doctoral degree OR, 3 full years of progressively higher level graduate education leading to such a degree or, LL.M., if related OR GS-11 Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experien