Supervisory Medical Benefits Systems Officer

Duties
For 0301-15:
Provide oversight and direction regarding the development, implementation, and operation of the Office of Workers Compensation Programs (OWCP) medical bill processing/provider network operations, and related functions and activities (e.g., claimant and provider inquiries, provider outreach, and fiscal operations).Supervise a staff of Federal professional employees and oversee large, complex bill process operations acquired through contracted services. Provides oversight, and advice that requires exceptional coordination and integration of a number of complex program segments for professional technical, or administrative work.Serve as a senior advisor by providing sound counsel and authoritative recommendations to the Branch Chief, Division Director, Deputy Director, and other senior officials regarding medical bill processing/provider network operations. In this capacity, the incumbent functions as the Project Manager (PM) with overall responsibility for managing broad and highly complex projects and employs strategic planning methods and technical advisory services through discussion of overall and specific problems, which may be precedent-setting, extremely involved, or very unusual, with senior executives and program managers.Function as the Project Manager (PM) or designate and oversee a PM, with overall responsibility for managing broad and highly complex projects and employs strategic planning methods and technical advisory services through discussion of overall and specific problems, which may be precedent-setting, extremely involved, or very unusual, with senior executives and program managers.Oversee customer experience (CX) efforts that include medical bill processing, provider, claimant and pharmacy benefits management perspectives. Ensure medical bill processing services are provided in accordance with industry standard approaches, in a professional, respectful, and compassionate manner that ensures equitable access to services for all claimants.Apply mastery project management skills to effectively develop, schedule, coordinate, and administer projects and resources to include monitoring and inspecting costs, work, and contractor performance. Define and establish project scope, requirements, and deliverables as well as short- and long-term system objectives.Requirements Conditions of EmploymentMust be at least 16 years old.Must be a U.S. Citizen.Candidate required to obtain the necessary security/investigation level.Requires a probationary period if the requirement has not been met.Subject to financial disclosure requirements.Requires a supervisory probationary period if the requirement has not been met. QualificationsIn describing your experience, please be clear and specific. Position titles alone cannot be used to determine if you are qualified. Please list dates in MM/DD/YYYY format. This is imperative in determining if you have at least one year of creditable specialized experience. Dates will not be assumed.
For the GS-15, applicants must have 52 weeks of specialized experience equivalent to at least the next lower grade level, GS-14 in the Federal Service.
Specialized Experience is the experience that equipped the applicant with the particular knowledge, skills, and abilities (KSA's) to perform the duties of the position successfully, and that is typically in or related to the position to be filled. To be creditable, specialized experience must have been equivalent to at least the next lower grade level.
Specialized experience for this position is defined as the following:
-Experience overseeing the processing of medical bills, ensuring compliance with healthcare billing standards, regulations, and best practices AND,
-Overseeing the planning, development, and implementation of initiatives to improve or modernize medical/healthcare billing systems, processes, and/or provider networks.EducationThis position does not have an education requirement.Additional informationThe mission of the Department of Labor (DOL) is to protect the welfare of workers and job seekers, improve working conditions, expand high-quality employment opportunities, and assure work-related benefits and rights for all workers. As such, the Department is committed to fostering a workplace and workforce that promote equal employment opportunity, reflects the diversity of the people we seek to serve, and models a culture of respect, equity, inclusion, and accessibility where every employee feels heard, supported, and empowered.Refer to these links for more information: GENERAL INFORMATION, REASONABLE ACCOMMODATION, ADDITIONAL DOCUMENTATION, FORMER FEDERAL EMPLOYEESAs a condition of employment, all personnel must undergo a background investigation for access to DOL facilities, systems, information and/or classified materials before they can enter on duty: BACKGROUND INVESTIGATIONYou may not be aware, but in the regulations for agency ethics programs, there are requirements for supervisors. Section 2638.103 of Title 5 of the CFR states: Every supervisor in the executive branch has a heightened personal responsibility for advancing government ethics. It is imperative that supervisors serve as models of ethical behavior for subordinates. Supervisors have a responsibility to help ensure that subordinates are aware of their ethical obligations under the Standards of Conduct and that subordinates know how to contact agency ethics officials. Supervisors are also responsible for working with agency ethics officials to help resolve conflicts of interest and enforce government ethics laws and regulations, including those requiring certain employees to file financial disclosure reports. In addition, supervisors are responsible, when requested, for assisting agency ethics officials in evaluating potential conflicts of interest and identifying positions subject to financial disclosure requirements.Supervisory Financial Disclosure: This position is subject to the confidential financial disclosure requirements of the Ethics in Government Act of 1978 (P.L. 95-521). Therefore, if selected, you will be required to complete a Confidential Financial Disclosure Report (OGE Form 450) to determine if a conflict or an appearance of a conflict exists between your financial interest(s) and your prospective position with DOL. This information will be required annually.Click here for Telework Position Information This is not a remote work position. The selectee will report to an assigned DOL office location on a regular basis and is eligible for participation in telework as determined by management in accordance with DOL policy.Based on agency needs, additional positions may be filled using this vacancy.The Department of Labor may use certain incentives and hiring flexibilities, currently offered by the Federal government to attract highly qualified candidates. Click here for Additional Information. The Fair Chance Act (FCA) prohibits Federal agencies from requesting an applicant's criminal history information before the agency makes a conditional offer of employment. If you believe a DOL employee has violated your rights under the FCA, you may file a complaint of the alleged violation following our agency's complaint process Guidelines for Reporting Violations of the Fair Chance Act. Note: The FCA does not apply to some positions specified under the Act, such as law enforcement or national security positions. Help

A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
Review our benefitsEligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.How You Will Be EvaluatedYou will be evaluated for this job based on how well you meet the qualifications above.Evaluation Factors (Competencies) - All qualified applicants will be evaluated on the following key competencies:Oral CommunicationProblem SolvingTechnical CompetenceTechnical CredibilityWritten CommunicationClick here for Evaluation details.You may preview questions for this vacancy here: The information you provide may be verified by a review of your paid, unpaid, volunteer, and other lived experience, as it demonstrates the competencies or skills required for the position to be filled. Your evaluation may include an interview, reference checks, or other assessment conducted by HR specialists, subject matter experts, or panel members and may include other assessment tools (ex. interview, structured interview, written test, work sample, etc.). The examining Office of Human Resources (OHR) makes the final determination concerning applicant ratings. Your resume MUST provide sufficient information to substantiate your vacancy question responses. If not, the OHR may amend your responses to more accurately reflect the level of competency indicated by the content of your resume.INFORMATION FOR ICTAP/CTAP ELIGIBLE(S) ONLY: If you are eligible for special priority selection under ICTAP/CTAP, you must be well-qualified for the position to receive consideration. ICTAP/CTAP eligible(s) will be considered well-qualified if they attain at least a rating score of 80 in a numerical rating scheme. Be sure to review the eligibility questions to reflect that you are applying as an ICTAP or CTAP eligible and submit supporting documentation.