Health System Specialist

Summary

Incumbent serves as a subject-matter authority on provider network management support functions, including provider credentialing, quality of care provided under the auspices of Program Office Care program operations and initiatives, and training. Administers resourcing, auditing, training, and evaluation of guidelines (e.g., policies) and program segment priorities to support healthcare administrative strategic goals, objectives for Veterans' health benefits, and the healthcare network.

Duties

Serves as a subject-matter authority researching issues, collecting data, designing and conducting audits of compliance with performance indicators related to Program Office operational initiatives. Serves as a member of teams/committees/workgroups related to and/or working on non-Agency healthcare initiatives and program efforts (e.g., data quality) and attends necessary engagements and conferences on effects with healthcare and hospital organizations. Develops reporting procedures, sampling techniques, and measurements at various points in the relationship process or operational cycle of private-sector/non-Agency healthcare provider network support and credentialing activities. Identifies problem areas or inherent weaknesses in work processes, procedures, information systems, and content. Consults with technical experts to develop purchased healthcare evaluation procedures and program controls to provide objective evidence of program evaluation effectiveness in administering delivery of healthcare as outlined in contracts. Provides policy guidance and advisory assistance to management in the development of strategies for evaluation of and quality controls on contracted delivery of healthcare under Program Office administration and operations. Assesses current and proposed guidelines and procedures and identifies aspects that indicate they are potentially unfeasible or result in an undeliverable reports or other information related to program operations. Provides authoritative information in discussions of healthcare provider credentialing and facility accreditation topics. Investigates and analyzes adverse findings, quality trends, or conditions and initiates corrective actions to ensure findings are addressed and reviewed against patient safety standards in the event of Veteran-care related issues. Monitors and evaluates quality of Program Office operational implementation and indicators and works to streamline and improve effectiveness of work practices and verify adherence to evaluation plans and requirements, reporting discrepancies to Program Office management. Work Schedule: Monday-Friday, 8:00am-4:30pm Compressed/Flexible: Available Telework: This position may be authorized for ad hoc telework. Ad hoc is defined as occasional, non-recurring telework. Return to Office (RTO): RTO mandates are in effect and selectees will be required to report to in-person work five days per week unless they are approved for an exception, an exemption, or extension while pending space assignment. Position Description/PD#: Health System Specialist/PD55915A 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, 11/16/2026. 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-12 position you must have served 52 weeks at the GS-11. 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-11 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Analyzing provider credentialing programs to evaluate compliance with healthcare regulations, accreditation standards, and VHA policy requirements. Evaluating healthcare facility accreditation findings to identify operational deficiencies and recommend corrective actions that improved organizational compliance. Applying healthcare management principles to resolve complex healthcare administration issues affecting the delivery of patient care services. Interpreting healthcare regulations, policies, and accreditation requirements to provide authoritative guidance on healthcare administration activities. Leading organizational studies or compliance audits to assess healthcare program effectiveness and develop recommendations for process improvement. Advising senior management officials through written reports and oral presentations regarding healthcare administration initiatives, regulatory requirements, and programmatic issues. AND Individual Occupational Requirement (IOR): In addition to the required specialized experience, you must also meet the IOR in one of the ways listed below: Undergraduate and Graduate Education: Major study -- hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. OR Specialized Experience 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. Special Provision for Inservice Placement: Successful completion of an agency-sponsored on-the-job training program may be substituted for qualifying experience, provided it included a formal individualized training plan. Such a training program must have been conducted in an operating health care system and included: Assignments providing a knowledge of basic health system administration philosophies, practices, and procedures, and basic government administrative policies and requirements; 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 Oversight by an experienced health system administrator with periodic evaluation of the individual's progress and appropriate adjustment of the training program. 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/.

Education

There is no educational