Summary This position is located in the Department of Veterans Affairs 0/A), Veterans Health Administration 0/HA), Mid Atlantic Health Care Network 0/ISN 6), Fayetteville VA Medical Center 0/AMC), in the Quality & Safety Service and works closely with VISN and Medical Center Leadership. This position develops and uses collaborative relationships with the other Medical Center disciplines to enhance the delivery of patient care to Veterans and provide educational experiences for the staff. Responsibilities This position independently performs assigned functions using sound administrative management principles, performance improvement methodologies, and current concepts from research and studies as a framework for practice. Provides direct staff support to all Service Chiefs and others in planning, designing, integrating, implementing, modifying, and administering a Medical Center-wide risk management program. The incumbent manages the day to day duties of the Risk Management program. Processes administrative tort claims and 1151 claims, reporting data as indicated to the Tort Claim Information System (TCIS) and is the primary liaison with Regional Counsel in matters relating to tort claim investigations. Coordinates reporting to the National Practitioner Data Bank upon recommendations from the Office of Medical Legal Affairs. Functions as a resource to the leadership team in the management of difficult situations requiring Administrative Investigation Boards. Serves as the Quality Management representative on hospital committees. Analyzes risk management data to identify trends, and determine efficiency and effectiveness of the program. Makes recommendations to Medical Center Leadership and Service/Service Line Managers based on the findings of this analysis. Responsible for development and maintenance of the following functional areas of the Medical Centers Quality Management Program: Tort and Other Claim Reviews Coordinates peer and administrative reviews subsequent to notification of claims alleging medical malpractice. Checks information from peer reviews and tort claims for accuracy. Ensures timeliness of reviews to meet mandated timeliness set by VHA. Maintain a database of all tort claims. Identifies and analyzes trends in settled tort claims. Manages the administrative tort claim process at the facility level and serves as a liaison with Regional Counsel and General Counsel's staff in matters relating to risk management issues.· Notifies, educates and guides providers on the appeals process. Completes NPDB report and enter information as required. Provide information in support of State Licensing Board(s) if requested Analyzes medical records and CPRS notes to retrieve information related to tort claims. Facilitate and respond to inquiries from patients related to procedures on filing claims. Coordinates with the offices of the Chief of Staff and the Associate Director, patient Care Services in the identification and notification of clinicians involved in the care of a Veteran who has filed a tort claim. Respond to inquiries from tort claim case peer reviewers and staff on correct procedures to complete the tort claim process. Coordinate and schedules review of Veterans Benefits Appeals cases. Manages the process for handling all small claims and those claims under $2,500. Administrative Investigation Boards Determines specific incidents that indicate the need for an Administrative Investigation Board. Provides technical assistance and training for Board members and ongoing training as needed for future Boards. Advises Board members on all aspects throughout the course of the investigation. Coordinates presentations of findings to leadership and follow up to recommended actions. Coordinates all logistical needs for the board members. Manages all aspects of the fund control point for Administrative Investigation Boards. Implements strategies for improvement in pro-active risk management, reduction of risk and liability for the facility, and in decreasing patient and employee injuries by working with the Medical Center committees. Management of Quality and Safety Participates in the management of quality, safety, and performance improvement activities. Assesses and evaluates the Risk Management Program to determine the program's effectiveness. Provides leadership, management, and appropriate committees and individuals with program analysis, evaluative materials, and summaries for the disclosure of adverse events. Work Schedule: Monday-Friday, 8-4:30p Telework: This position may be authorized for telework on an ad-hoc basis. Telework eligibility will be discussed during the interview process. Virtual: This is not a virtual position. Position Description/PD#: Health Systems Specialist (Risk Manager)--DETAIL/TEMP PROMOTION NTE 120 DAYS/PD082760 Requirements Conditions of Employment You must be a U.S. Citizen to apply for this job Selective Service Registration is required for males born after 12/31/1959 You may be required to serve a probationary/trial period Subject to background/security investigation Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) Qualifications To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 09/12/2025. 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. Preferred Experience: A minimum of five years of successful clinical nursing practice and must demonstrate knowledge of current concepts and principles of Quality Improvement; and the Joint Commission Risk Standards and Office of Inspector General (OIG) Review process that relates to the principles and functions of Risk Management and the Peer Review Process. Preferred Education: Bachelors or Masters degree in Nursing from a National League for nursing accredited program or from a field related to Nursing 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-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: Progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care field. Knowledge of the risk management program, policies, and techniques to manage day-to day risk management program activities for the Medical Center such as develop internal monitoring to identify trends and potential risks; initiate, develop, and draft local policies and procedures; and develop corrective actions plans and make recommendations to improve effectiveness and efficiency. Knowledge of the health care delivery system's programs, missions, organization, and principles, including regulatory and procedural guidelines, and the inter-relationship between health care delivery systems in the Department of Veterans Affairs. Knowledge of various management techniques including statistical analysis, short and long range planning, work measurement techniques, qualitative analysis, program planning, and computer data base management to evaluate and recommend ways to improve risk management effectiveness and efficiency. Ability to manage databases to design and implement control/tracking systems for - monitoring and trending data and assuring timely initiation, and submission of reports and projects. - Ability to analyze data, recognize trends, use statistical analysis and suggest solutions to identified problems independently to conduct studies, analyzing findings and make recommendations on risk management programs. Ability to present both written and oral recommendations taking into full consideration the wide range of factors and requirements which affect the management of the health care delivery system. General knowledge of Medical Center administrative and clinical operations. This includes knowledge of regulatory and procedural guidelines pertaining to health care systems. Knowledge and skills of Performance Improvement strategies. 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. You will be rated on the following Competencies for this position: Change Management Database Administration Financial Systems Risk Management Written Communication 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: This work requires some mobility but is generally sedentary and may be performed form a seating position. Overnight travel can occur. 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 substitution at this grade level. A transcript must be submitted with your application if you are basing all or part of your qualifications on education. Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.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 This job opportunity announcement may be used to fill additional vacancies. If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement. Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.
