Summary This position will be assigned to the Health Benefits Unit of the Health Administration Service, Central Virginia Health Care System, Emergency Department. The incumbent provides a high level of administrative and data support. Responsibilities The primary function of this position is to make eligibility determinations for VA healthcare which requires an extensive knowledge of VA laws, directives, policies and procedures. They will also be responsible for running data reports for unverified status of applications, incomplete encounter management errors due to any administrative data input and updating demographic information. Incumbent will serve as advisor and expert to the HAS Section Chiefs and support the management information components of all health eligibility related programs. The incumbent reviews, verifies, and analyzes data submitted for consistency with financial and program objectives, and adherence to VA directives. The incumbent's responsibilities include management analyst, training, and organizational development. This includes not only entering data and information, when necessary, but also reviewing reports, records and statistical computations for accuracy and propriety. Local input is compared with the Health Eligibility Center (HEC) in Atlanta, GA and will affect data entry for encounter entries that go to Austin for workload credit. The incumbent must review the Incomplete Encounter Management Module (IEMM) report to clean up any discrepancies in administrative data that would prevent the transmission of encounters. Responsible for performing work to support the Enrollment Coordinator/Supervisory MSA to include all administrative processes, health benefits eligibility determinations, and all aspects of the health benefits package. Performs technical activities involved with screening, processing, and assisting Veterans, non- Veterans, and beneficiaries seeking multiple medical treatment benefits. Provides information regarding benefits to Veterans and responds to complex questions involving regulations and/or beneficiary entitlement; communicates results to patients, families, agency employees, and Veterans organizations. Reviews and processes VA healthcare eligibility in conjunction with Department of Defense (DoD) Sharing Agreements (TriCare and CHAMPVA) to determine eligibility for VA health care referencing multiple sources, such as the Health Eligibility Center (HEC), Veterans Information System (VIS), Defense Personnel Records Image Retrieval System (DPRIS), Individual Longitudinal Exposure Record (ILER) and or/military discharge papers to assign a priority group to the Veteran. Reviews and processes new and recurring applications (paper, in-person, and electronic) for medical care (e.g., Dental, Behavioral Health, Geriatrics and Extended Care, Diagnostic and Therapeutic, etc.) through applying the appropriate regulatory authority to each program. Processes re-enrollment into the system and assists Veterans in changing facilities if necessary. Incumbent will be assigned to the Emergency Department but may be asked to perform duties in other areas of the Health Administration Service and provide back up as needed. VA Careers - Medical Support Assistant: https://youtube.com/embed/EE9c4XkaELo Work Schedule: 12am-8:30am (rotating weekends and holidays) Compressed/Flexible: Not Available. Telework: Not Available Virtual: This is not a virtual position. Functional Statement #: 000000 Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized. PCS Appraised Value Offer (AVO): 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. Must be proficient in written and spoken English. 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 identification 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). Complete all application requirements detailed in the "Required Documents" section of this announcement. As a condition of employment for accepting this position, you will be required to serve a 1 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 Federal service. Upon completion of your trial period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest. Qualifications Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Education: High school diploma, General Education Development equivalency certificate, or proficiency certificate from a State or territorial-level Board or Department of Education. Foreign Education: To be creditable, education completed outside the U.S. must be deemed at least equivalent to that gained in a conventional U.S. program by a private organization specializing in the interpretation of foreign educational credentials. English Language Proficiency: Candidates must be proficient in spoken and written English in accordance with 38 U.S.C. § 7403(f). May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Documentation Requirements for Proof of High School Completion or higher: If selected, to meet the basic requirement of high school education or equivalent and prior to a firm job offer being extended, applicants must provide one of the following as verification of the education requirement if not covered under the grandfathering provision: Copy of high school diploma OR high school transcript (unofficial or official) OR GED Certificate OR homeschooling completion OR proficiency certificate issued by a State or Territorial Board or Department of Education OR college transcript (official) Grade Determination: One (1) full year of creditable experience equivalent to the GS-5 grade level and the Knowledge, Skills, and Abilities (KSAs) listed below. Advanced knowledge of the technical health care process (including, but not limited to, scheduling across interdisciplinary coordinated care delivery and/or care in the community models and patient health care portals) as it relates to access to care. Advanced knowledge of policies and procedures associated with interdisciplinary coordinated care delivery and/or care in the community operational activities that affect patient flow, and patient support care administrative functions to include, but not limited to appointment cycles, outside patient referrals, follow-up care, overbooking, provider availability, etc. Advanced knowledge of medical terminology due to the technical nature of language utilized by clinicians. Ability to collaborate and communicate with a wide range of medical clinicians across multiple disciplines (e.g., medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical pharmacists, and nursing staff) to accomplish team goal setting to ensure medical care to patients is met. Ability to independently set priorities and organize work to meet deadlines, ensuring compliance with established processes, policies, and regulations. Ability to communicate tactfully and effectively, electronically, by phone, in person, and in writing, with internal and external customers. This may include preparing reports in various formats and presenting data to various organizational levels, as well as resolving patient concerns. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. The full performance level of this vacancy is GS-6. Physical Requirements: See VA Directive and Handbook 5019, Employee Occupational Health Service for requirements. 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 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. Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience. 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. During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions. This job opportunity announcement may be used to fill additional vacancies. This position is in the Excepted Service and does not confer competitive status. VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority. 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.
