Health System Specialist

1 month ago

Albuquerque, United States Veterans Health Administration Full time

The primary purpose of this position is to provide support to health care management officials by analyzing, evaluating, advising on and/or coordinating health care delivery systems and operations. The position renders advice on operational policies and assures these policies are coordinated with, and in support of, field operations.

Duties include but are not limited to:
Primary liaison to multiple staff offices and serves as the conduit for information flow and management of assignments between such offices.
Monitors and manages incoming actions and requests from initial receipt to completion and closeout.
Provides guidance and counsel on incorporating compliance­ related activities into operations areas.
Instill the elements of the Office of Inspector General's model compliance plan into the VHA Compliance program.
Distribute written policies and procedures that promote commitment to compliance and address specific areas of potential fraud, such as billing, collections, and coding.
Performs an annual system wide prioritized risk assessment, develops and/or provides effective education and training programs for all affected employees to mitigate identified risks, develops and/or performs auditing and monitoring of identified risk areas, including newly identified risks throughout the year; assists service lines departments in developing appropriate monitoring and auditing processes that mirror facility goals.
Maintenance of a process, such as a helpline, to receive complaints, and the adoption of procedures to protect the anonymity of complainants.
Maintains high visibility and an open-door policy to encourage employees to report potential compliance issues.
Conducts investigation and remediation of system problems identified through the helpline, employee and patient communications, and interaction with professional counterparts.
Develops policies addressing the non-employment or retention of sanctioned individuals.
Responds and takes appropriate action to allegations of improper/illegal activities and regulations, or federal health care program requirements.
Develops, coordinates and/or conducts audits and/or other evaluation techniques to monitor compliance and to assist in the reduction of identified problem areas.
Reviews periodic reports with senior management detailing compliance initiatives throughout the year and recommends changes and improvements to the VA Loma Linda CBI program and operational compliance related activities.
May chair and/or Co-chair the VA CBI Committee and provides ongoing and consistent reports, feedback, and outcomes to the VISN CBIO.
Analyzes audit results, develops educational tools to address audit findings, and recommends system changes, as appropriate.
Manages and coordinates of all online communication tools such as assigned intranet, websites, internal SharePoint website collection, and other related informational tools in consultation with communication specialists.
Assures compliance with all applicable policies, and development and maintenance of internal management processes related to these online tools.
Develops long-range program plans, goals, objectives, and milestones or evaluates the effectiveness of programs conducted throughout an agency, or a regional structure of equivalent scope.
Identifies and develops ways to resolve problems or cope with issues which directly affect the accomplishment of principal program goals and objectives.
Develops new ways to resolve major administrative problems or plans the most significant administrative management aspects of professional or scientific programs.
Develops administrative regulations or guidelines for the conduct of program operations or new criteria for measuring program accomplishments.
Responsible for familiarization of how his/her activities impact the VA goals for implementing sound environmental practices. In accordance with the GEMS program, seeks to meet, or exceed, compliance with federal, state, local and VA environmental, public health, and resource conservation laws, regulations and requirements in a cost-effective manner.



Work Schedule:
Monday-Friday, 8:00am-4:30pm


Compressed/Flexible:
Supervisor's discretion


Telework:
VA supports the use of telework as a way to help attract and retain talented individuals in public service, increase worker productivity, and better prepare the agency to operate during emergencies. This position may be authorized for telework. Telework eligibility will be discussed during the interview process.


Virtual:
This is not a virtual position.


Position Description Title/PD#:
Health System Specialist/PD12957A


Relocation/Recruitment Incentives:
Not Authorized


Critical Skills Incentive (CSI):
Not Approved


Permanent Change of Station (PCS):
Not Authorized

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