Summary The primary purpose of this position is to serve as a Lead Health System Specialist (PRC Technician Lead) with the Purchased Referred Care program. This position is located under the Indian Health Service, Mid-Atlantic Service Unit in Richmond, VA. The position will eventually be located with the Mid-Atlantic Tribal Health Center in Charles City, Virginia. Responsibilities Conducts analysis of applicable policies and directives pertinent to the administration and management of the Purchased Referred Care program. Provides input for development and revision of operation, acquisition, and procurement plans and guidelines. Leads and provides guidance in patient registration, billing, benefit coordination and accounts receivables functions. Analyze and develop goals and projections for third party collection. Develop, prepare and analyze statistical reports for compliance with internal control requirements. Utilizes automated data processing equipment, electronic health records, UFMS and RPMS to achieve program goals. Lead revenue generation strategies in collaboration with business office and medical department staff. Verifies patient eligibilities with medical referrals, patient registration, and insurance billing verification. Other duties as assigned. Requirements Conditions of Employment Selectee may be subject to a probationary/trial period. ESEP appointees typically serve a two-year trial period. U.S. Citizenship is required. Selective Service Registration is required for males born after 12/31/1959. This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children. Due to this requirement, the agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes. Measles and Rubella immunization required for selectees born after 1957 and seasonal influenza immunization is required for all staff working in Indian Health Service health care facilities. COVID-19 vaccination is required for all selectees prior to entrance on duty. Successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit www.dhs.gov/E-Verify/. You will need to set up direct deposit so we can pay you. Background Investigation: If you are selected for this vacancy, you must undergo a pre-employment fingerprint check and background investigation. Fingerprint results and background investigation documentation must be cleared prior to hire. After you begin your employment, your continued employment is contingent upon the outcome of a complete background investigation as determined by the sensitivity level of your position. The investigation must find that you are suitable for Federal employment in your position. If you are found not suitable, you will be terminated after you begin work. If you make a false statement in any part of your application, you may not be hired; you may be fired after you begin work; or subject to possible criminal charges. You may be subject to a credit check as a part of the background investigation process. Qualifications To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying. 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; religious; spiritual; community; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week. MINIMUM QUALIFICATIONS: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: coordinates PRC, third party resources and funds reconciliation activities; trains and assigns work activities to staff, reviews, accepts/rejects work; leads in the implementation of principles of managed care; consults with executive staff for the appropriate use of PRC related to IHS direct care service; prepares operating procedures and quality improvement operations; recommends job description changes, performance standards, performance appraisals, etc., for staff; proficient in CHSMIS data system; monitors PRC funds and prepares reports that reflect status and utilization of resources. This definition of specialized experience is typical of work performed at the second lower grade/level position in the federal service (GS-07). OR Education: Master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such in a field which demonstrates the knowledge, skills, and abilities necessary to do the work of the position, such as: hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. (Note: You must attach a copy of your transcripts.) OR Combination of Education and Experience: A combination of education and experience may be used to qualify for this position as long as the computed percentage of the requirements is at least 100%. To compute the percentage of the requirements, divide your total months of experience by 12. Then divide the total number of completed graduate semester hours (or equivalent) beyond the first year (total graduate semester hours minus 18) by 18. Add the two percentages. (Note: You must attach a copy of your transcripts.) Time In Grade Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP). You must meet all qualification requirements within 30 days of the closing date of the announcement. Education If qualifying based on education alone, you are strongly encouraged to submit a copy of your transcripts or a list of your courses including titles, credit hours completed, and grades. Unofficial transcripts will be accepted in the application package. Official transcripts will be required from all selectees prior to receiving an official offer. Only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education may be credited. Applicants can verify accreditation at the following website: https://www.ed.gov/accreditation. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit https://sites.ed.gov/international/recognition-of-foreign-qualifications/. Additional Information Per IHS policy (SGM 21-04) IHS selectees to positions located in Federally operated hospitals, health centers, and clinics must be fully vaccinated for COVID-19 before entry on duty or have IHS approve a medical or religious exemption. If an exemption is approved then wearing a face mask and regular testing for COVID-19 will be required. Your Human Resources Specialist will provide a list of documents acceptable as vaccination proof and instructions on how to submit your vaccination documentation or how to request a medical or religious exemption, if needed. Additional selection(s) of candidates may be possible within 240 days from the date the certificate of eligibles was issued for this announcement. Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. IHS may offer newly-appointed Federal employees credit for their directly related previous non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave. Recruitment or relocation incentives may be authorized. At least a 6 month service agreement will be required. This position meets the criteria specified in pillar number one of the five pillars of the PHS Commissioned Corps. PHS Commissioned Officers interested in performing the duties of this position within the Commissioned Corps MUST apply online under the merit promotion announcement indicated above in order to receive consideration. For more information on PHS Commissioned Corps, visit the website at: https://www.usphs.gov/. This position is at the full-performance level. This position is being announced concurrently under Delegated Examining Procedures. Please review vacancy announcement number IHS-24-NA-12459921-DE; for eligibility requirements. NOTE: Applicants must apply separately for each announcement in order to be considered.