Description du poste
This position 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. Applicant Count: This job announcement will automatically close at 11:59pm EST on the date the applicant count of 100 applications has been reached or on the closing date, whichever comes first.
PRINCIPALES MISSIONS :
***THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION*** Duties may include, but are not limited to the following: Serves as the subject matter expert on healthcare provider credentialing and facility accreditation, evaluating the quality, accuracy, and compliance of credentialing and accreditation activities performed by contracted organizations. Reviews and analyzes credentialing, accreditation, and provider qualification data to identify trends, risks, compliance concerns, and opportunities for improvement, and communicates findings to leadership. Develops and conducts audits, reviews, and performance assessments of contractor-managed credentialing and accreditation processes to ensure providers and healthcare facilities meet required standards, contractual requirements, and industry best practices. Evaluates the effectiveness of credentialing, recredentialing, primary source verification, accreditation, and related quality assurance processes conducted by contracted credentialing and verification organizations. Monitors contractor performance to ensure healthcare providers and facilities are credentialed, verified, and accredited in accordance with applicable standards, policies, regulations, and contract requirements. Provides expert guidance to leadership on healthcare credentialing, accreditation, provider qualifications, regulatory requirements, industry standards, and emerging trends affecting healthcare quality and patient safety. Collaborates with contractors, healthcare organizations, accrediting bodies, and internal stakeholders to address audit findings, compliance concerns, corrective action plans, and quality improvement initiatives related to credentialing and accreditation programs. Represents the organization in meetings, workgroups, and professional forums involving healthcare credentialing, accreditation, provider quality, and compliance matters. Performs other related duties as assigned. Work Schedule: Monday-Friday, 8:00am-4:30pm Recruitment & Relocation Incentives: Not authorized Critical Skills Incentive (CSI): Not Approved Telework: This position may be authorized for telework. Telework eligibility will be discussed during the interview process.
QUALIFICATIONS REQUISES :
This position includes a Selective Placement Factor (skill, knowledge, ability or other worker characteristic basic to - and essential for - satisfactory performance of the job). Selective Placement Factors are a prerequisite to appointment and represent minimum requirements for a position. Applicants who do not meet it are ineligible for further consideration. The Selective Placement Factor for this position is: "Possess experience developing and evaluating programs specifically related to healthcare provider credentialing and facility accreditation." ~AND~ In addition to meeting the Selective Placement Factor, to qualify for this position at the GS-12 grade level, you must meet the following: SPECIALIZED EXPEREINCE: Have at least one (1) year of specialized experience directly related to this position. To be creditable, this experience and education must have been equivalent to at least the next lower grade level (GS-11) in the Federal Service that is directly related to the position. Specialized experience includes: progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care field. This work may have been performed in an operatin