Summary
This position is the Clinic Profiler for the medical facility and satellite clinics/healthcare system (Facility). This position provides a high level of complex and highly skilled support related to provider profile management. Coordinates clinical/provider profiles and scheduling grids, including but not limited to clinic set up and clinic maintenance.
Responsibilities
The incumbent will perform the duties outlined under closer supervision. MAJOR DUTIES: Responsible for overall program management for the clinic maintenance process for the Facility and leads the facility's efforts to integrate profile management among healthcare providers, other facility staff, and patients. Set up the clinic structure, allowing the scheduling of patients, direct workload capture, direct insurance and co-pay billing, direct MCA costing, and track facility and provider performance against national, Veterans Integrated Network (VISN), and local measures. Interprets national policies and procedures, developing and implementing local standards, defining requirements and providing advice to top management on related issues pertaining to clinic/provider profile management. Ensures that completed profiles reflect national, network and local goals, directives, and policies. Integrates advanced clinic access (ACA) principles and initiatives, outpatient scheduling directive mandates, ambulatory data capture and workload rules and regulations, coding and billing criteria, MCA requirements into clinic structures. Responsible for establishing and managing communication plans that identify target audience, appropriate messages, activities, and resources needed for effective communication, and communication plans for change management, incorporating multiple channels to manage expectations and disseminate project progress. Oversees clinic supervision to staff delegated to services performing clinic profile coordination and management functions. Leads clinic profile team members to ensure analytics, goals, are being met using accurate and timely clinic management tools for their designated services/clinics. Coordinates all administrative needs of clinic profile building and maintenance, establishing the program goals, evaluating implementation, and data capture components for the Facility. Provides technical advice to clinic personnel primarily at the clinic director and Patient Service Line (PSL) management level regarding scheduling, clinic profiles and workload. Facilitates efficient and effective communication between Program Analysts (ADPAC)s, MCA, encounter form specialists, billing specialists, and assigned service to ensure accuracy of workload transmission and when new scheduling software is installed/implemented. Evaluates computer generated appointment types and determines appropriate assignments of appointment type on a timely basis. Determine if excess future appointment slots need to be redistributed and/or additional slots need to be added. Coordinates with informatics for development and management of data systems, assisting and creating the basis for data driven decision-making of clinic profile operations management. Determines best method to collect requested data from a variety of multiple sources, compiles statistics and other data. Performs data retrieval and analysis for reports; prepares Facility reports to monitor accuracy and utilization regarding clinic profile management and communicates to appropriate Facility groups for action. Identifies problems and applies analytical techniques, correcting negative trends and provides resolutions to system issues/malfunctions, to include encounter and transmission errors, clinic grids and other issues related to clinic profile management. Investigates complaints from internal and external customers related to clinic profile set up and resolves the complaint or escalates to the appropriate manager. Develops and implements an in-depth training program for the Facility to ensure staff are properly educated and accountable for clinical profiles, scheduling, and data management. Instruction is to ensure correct clinic profile mapping, scheduling procedures for all scheduling applications, overbooking, cancelations etc., are in compliance with national directives and other facility policies Retrieves & analyzes data for validation of clinic set up information to include billable status, count vs. non-count, DSS (MCA) identifiers and activation of encounter forms, standard naming conventions, accurate grids and all other parameters of the clinic profile. Reviews reports, records, and provides statistical analysis for accuracy in clinic profile management by accessing data, presenting alternatives, making recommendations, and assisting with developing problem resolutions. Performs other duties as assigned. Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level. Work Schedule: Monday - Friday 8:00 am - 4:30 pm
Telework: Yes
Virtual: This is not a virtual position.
Position Description/PD#: Program Analyst/PD99898S
Relocation/Recruitment Incentives: Not Authorized
Financial Disclosure Report: Not required
Requirements
Conditions of Employment
Qualifications
To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 04/23/2021. 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-09 position you must have served 52 weeks at the GS-07; For a GS-11 position you must have served 52 weeks at the GS-09. The grade may have been in any occupation, but must have been held in the Federal service. . NOTE: 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 and/or education as described below: GS-9 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-07 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: processes data in mainframe databases; maintains a high level of integrity of data, which includes identifying all significant technical and administrative adjustments to data; analyzes clinical workload extracts; and validates clinical source data with data. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have successfully completed a Master's degree or 2 full years of progressively higher level graduate education leading to such a degree or LL.B. or J.D., with major study in business administration, accounting, finance, hospital administration and/or management, allied health and medical, or other fields related to the position. NOTE: YOU MUST SUBMIT COPIES OF YOUR OFFICIAL TRANSCRIPTS for your education to be considered. OR, Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education equivalent to the experience and education requirements above. GS-11 Specialized Ex