Health System Specialist - Credentialing and Privileging Specialist (C&P)
Veterans Affairs, Veterans Health Administration
Summary The incumbent is assigned to the Medical Staff Office, which is under the Chief of Staff at a VA Medical Center (VAMC) and is responsible for providing administrative and technical direction and support to the credentialing and privileging (C&P) operations. The C&P Specialist is aligned to and supervised by the C&P Manager. Responsibilities Duties include but are not limited to: Assists the C&P Manager/Analyst in developing short- and long-term goals necessary to accomplish the mission of the C&P program. Assists in identifying the resources necessary for accomplishing the mission and function of the credentials and privileging program. Serves as SME in the field of credentials and clinical privileging. Keeps leadership and appropriate administrative staff informed of program changes, new regulatory requirements, and policies and procedures pertaining to the C&P process. Assists C&P Manager/Analyst in drafting local credentialing processes and Medical Staff Bylaws in compliance with all applicable regulations. Receives and reviews correspondence and communications for the C&P function and determines which items require immediate attention and which are confidential in nature. Receives and reviews VetPro reports detecting problem areas requiring further investigation. Upon identification of a problem, researches reference materials, regulations, and standards to identify appropriate action necessary to correct the problem. Issues of a serious nature are elevated to the supervisor for guidance. Ensures accurate provider data is entered into and maintained in the VetPro computer program. Ensures current information is present on providers relative to state licensure, Drug Enforcement Organization (DEA) license, National Practitioner Data Bank (NPDB) Continuous Query (CQ) enrollments and renewals, Federation of State Medical Boards (FSMB), documentation of professional education, specialty medical training, certifications, adverse licensure or privileging actions, initial and renewal of privileges which may affect the status of privileges granted for medical practice. Informs C&P Manager/Analyst of trends identified, audit results and identified problems that may affect a provider's privilege status. Assures application packages and other documents meet technical requirements per specialty of provider and assures application folder and database account (VetPro or other internal databases and spreadsheets) meet technical requirements. Communicates with LIPs to assure timely completion of applications and VetPro requirements. Provides oversight to application process; analyzes exceptions and deviations in expected application process; determines course of action and makes recommendations. Determines processes for coordination of incoming data and documents from a variety of sources. Documents include, but are not limited to, VA applications for employment, primary source verifications of education and training, peer recommendations, licensure, DEA license, board certification, NPDB CQ reports and personal history, and malpractice claims, FPPE, OPPE, etc. Reviews documents and applications for omissions and inconsistencies and assures data entry is complete and accurate to meet VHA policy and regulation, and TJC standards. Reviews documents received and determines course of action based on information provided within Work Schedule: Monday - Friday 8:00am - 4:30pm Compressed/Flexible Work Schedule: Not Authorized Telework: Not Authorized Virtual: This is not a virtual position Position Description/PD#:Health System Specialist - Credentialing and Privileging Specialist (C&P) /PD99876S Relocation or Travel Incentives: Not Authorized Recruitment Incentives: Not Authorized Financial Disclosure Report: Not Required Notifications: This position is not a Bargaining Unit position. Selectee may be required to work at any VA Connecticut Healthcare System campus, as needed. May be required to attend conference at other facilities or other VA sites on occasion. The incumbent may be required to travel to other VA campuses and CBOC's. Selectee may be required to work at any VISN 1 Healthcare System campus, as needed. Current and former Federal employees must submit copies of their most recent SF-50 (Notice of Personnel Action). The SF-50 must identify the position title, series, grade, step, tenure and type of service (Competitive or Excepted). In some cases, more than one SF-50 may be required to show a higher grade previously held. This position is in the Competitive Service. Time-in-Grade Restriction: 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. The grade may have been in any occupation but must have been held in the Federal service. Veterans' preference does not apply for other current permanent Federal agency employees. Requirements Conditions of Employment Qualifications To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 09/08/2025. 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-09 position you must have served 52 weeks at the GS-07. 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. INDIVIDUAL OCCUPATIONAL REQUIREMENT: Positions in the occupational series 0671 MUST MEET 1 of the following bullet points: Possess an Undergraduate or Graduate degree with a major field of study in hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. (TRANSCRIPT REQUIRED) OR; Possess progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care field. 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. OR; Successful completion of an agency-sponsored on-the-job training program may be substituted for qualifying experience, provided it included a formal individualized training plan. Such a training program must have been conducted in an operating health care system and included: Assignments providing a knowledge of basic health system administration philosophies, practices, and procedures, and basic government administrative policies and requirements; Practical assignments providing an opportunity to apply health system administration skills and principles (as the individual progresses, work assignments must be characteristic of the grade level to which he or she is assigned); and Oversight by an experienced health system administrator with periodic evaluation of the individual's progress and appropriate adjustment of the training program. GRADE REQUIREMENTS You may qualify based on you meeting one of the three requirements below GS-09 Specialized Experience: One year of specialized experience (equivalent to the GS-07 grade level in the federal service); experience that equipped the applicant with the particular knowledge, skills and abilities (KSA's) and other characteristics to perform successfully the duties of the position, and that is typically in or related to the work of the position to be filled, in the normal line of progression for the occupation in the organization. Specialized experience includes: performing duties ensuring accurate provider data is entered into and maintained in the VetPro computer program. Ensuring current information is present on providers relative to state licensure, Drug Enforcement Organization (DEA) license, National Practitioner Data Bank (NPDB) Continuous Query (CQ) enrollments and renewals, Federation of State Medical Boards (FSMB), documentation of professional education, specialty medical training, certifications, adverse licensure or privileging actions, initial and renewal of privileges which may affect the status of privileges granted for medical practice. Informing C&P Manager/Analyst of trends identified, audit results and identified problems that may affect a provider's privilege status. OR, Education: Must have successfully completed a master's or equivalent graduate degree or successfully completed two (2) full years of progressively higher level graduate education leading to such a degree. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work of this position (i.e., hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration). The education portion must include courses that demonstrate the knowledge, skills, and abilities necessary to do the work of this position. Education must have been obtained in an accredited college, or university. NOTE: Transcripts must be submitted with your application materials. Education cannot be credited without documentation. OR, Combination: Must have an equivalent combination of successfully completed education and specialized experience directly related to the work of the position as outlined above that meets the requirements of the position. Only education in excess of the first year (18 semester hours) may be used to qualify applicants for the GS-09 level. NOTE: If using education combined with specialized experience to qualify, a copy of your transcript is required. You will be rated on the following Competencies for this position: Analysis and Problem Solving Critical Thinking Customer Service (Clerical/Technical) Decision Making Information Management 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: The work is mostly sedentary. Occasionally, light physical effort may be required, such as that involved with walking, stair climbing, and carrying of light office items. The work is performed in an office setting which requires normal safety precautions typical for offices and meeting rooms. The work area is adequately lighted, heated, and ventilated. The work may require travel 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/. 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. Education 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. 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. 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 well-qualified, applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors if applicable, and must be proficient in most of the requirements of the job. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website which can be found at https://www.opm.gov/. 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. Financial Disclosure Report: Not required This job opportunity announcement may be used to fill additional vacancies.
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