Summary The primary functions of the incumbent are to assist the Primary Care/Managed Care Product Line (PC/MC PL), in providing advisory and technical assistance to beneficiary patients seeking medical care, information or guidance from the contracted Community Based Outpatient Clinics (CBOC). The incumbent is assigned as a Program Assistant in the Primary Care Managed Care Product Line of the South Texas Veterans Health Care System (STVHCS). Responsibilities Major Duties: Data Analysis: The PA is responsible for the accountability of over 23 million dollars for CBOC contract services. The incumbent obtains information from the various contracts as they relate to payment rates and prepares monthly enrollment listing for payment of services performed at each CBOC. She/He reviews and analyzes bills received for payment to: (1) ensure charges are within negotiated contract; (2) eliminate any unnecessary or duplicate charges; (3) verify the patient was seen at the facility in question; (4) validate bills against actual patient information. Incumbent is the point-of-contact for billing inquiries for the various CBOC contracts. Handles patients concerns and issues and working with the Program Specialist to ensure all the needs of the Veterans are met timely. Handles suspenses assigned timely and ensure all the needs of the contract needs are met. Incumbent is responsible for maintaining up-to-date financial fund control point obligations. This includes establishment of 1358's, 2237's, and decreasing and increasing obligations as necessary. She/He utilizes the Veteran's Health Administration (VHA) Financial Management System (FMS), Control Point Activity, Accounting and Procurement (IFCAP) to monitor both the obligated and unobligated balances. The PA assists the CBOC Program Specialist in projecting the need for additional funding requirements to senior management. Administrative Duties: The incumbent works closely with the CBOC Program Specialist. He/She assists CBOC Program specialist in orienting and advising the CBOC personnel regarding the VA regulations, policies and procedures on administrative matters, basic eligibility for benefits and status for evaluation into CBOC. Through constant surveillance, maintains contact with medical and administrative staff in various areas/services to resolve delays and misunderstandings in the medical administrative aspects of providing medical care. Work Schedule: Monday-Friday / 0800-1630 Virtual: This is not a virtual position. Position Description/PD#: Program Assistant/PD008270 Relocation/Recruitment Incentives: Not Authorized Requirements Conditions of Employment You must be a U.S. Citizen to apply for this job To be considered for this position, you must complete all required steps in the process. In addition to the application and questionnaire, this position requires an online assessment. The online assessment measures critical general competencies required to perform the job. Selective Service Registration is required for males born after 12/31/1959 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) As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period or 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider: your performance and conduct; the needs and interests of the agency; whether your continued employment would advance organizational goals of the agency or the Government; and whether your continued employment would advance the efficiency of the Federal service. Upon completion of your probationary period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest. Qualifications To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 02/02/2026. 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-06 position you must have served 52 weeks at the GS-05. 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-05 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: obtains information from the various contracts as they relate to payment rates and prepares monthly enrollment listing for payment of services performed; reviews and analyzes bills received for payment to: (1) ensure charges are within negotiated contract; (2) eliminate any unnecessary or duplicate charges; (3) verify the patient was seen at the facility in question; (4) validate bills against actual patient information. Knowledge of billing inquiries for various contracts. Knowledge on maintaining up-to-date financial fund control point obligations. You will be rated on the following Competencies for this position: Customer Service Administration and Management Contracting/Procurement Physical Requirements: Work is mostly sedentary with some walking, bending, standing in completing various stages of the daily tasks and carrying of light objects such as supplies and documentation manuals and records. There will be some lifting and transferring of baskets or boxes of supplies and records more than 15 pounds. The incumbent must have adequate eyesight and hand dexterity to allow for reading and operating a computer keyboard. The incumbent is required to answer numerous personal/telephonic inquiries and must have adequate eyesight and hand dexterity to allow for reading and operating a computer. 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. Additional Information 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. Reasonable Accommodation (RA) Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments if you received the link after the close of the announcement. To determine if you need a RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments. Receiving Service Credit for Earning Annual (Vacation) Leave: 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. VA may offer newly-appointed Federal employee's credit for their job-related 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. Such credit must be requested and approved prior to the appointment date and is not guaranteed. This job opportunity announcement may be used to fill additional vacancies. The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced VA competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation (a copy of the agency notice, your most recent performance rating, and your most recent SF-50 noting current position, grade level, and duty location) and be found well-qualified for this vacancy. To be well-qualified: applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the required competencies of the job. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website at http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/.
