Program Specialist

Veterans Health Administration

Prescott, AZ

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JOB DETAILS

SKILLS

Analysis Skills, Budgeting, Call Centers, Community Programs, Community Providers, Credit Reports, Customer Support/Service, Data Processing, Department of Veterans Affairs, Documentation, Federal Government, Government, Healthcare, Hospital, Human Resources, Identify Issues, Leadership, Legal, Onboarding, Operations Processes, Operations Security (OPSEC), Patient Care, Performance Analysis, Physical Demands, Problem Solving Skills, Process Improvement, Program Evaluation, Record Keeping, Regulatory Requirements, Relationship Management, Reporting Skills, Resolve Customer Issues, Service Delivery, Trend Analysis, United States Citizen, Vaccination

LOCATION

Prescott, AZ

POSTED

1 day ago

Summary

The Northern Arizona VA Health Care System is currently recruiting for one Program Specialist (Patient Representative) in the Community Care Service, Prescott, Arizona. The incumbent conducts reviews in the areas of community care coordination and payment of claims related tocare in the community with the Budget Analyst to attempt and resolve concerns from Veterans and community providers

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Duties

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The incumbent conducts reviews as required by their direct supervisor and medical center leadership. Other duties include, but are not limited to, the following:

Contact members of the hospital staff at all levels concerning patient care issues not been resolved by other services and seeks resolution utilizing the full resources of the medical center and VA system.
Explore all avenues, crossing lines of authority and responsibility within the medical center, to identify the nature and scope of the problem and to initiate appropriate action for resolution.
Independently resolves the most difficult, complex, and sensitive care issues and system-related problems, applying advanced judgement across multiple program areas and organizational levels.
Gather, analyze, and prepares information using sound judgement in response to inquiries, including Congressional Offices, White House Hotlines, Advance Credit Reports (ACR), VAIQs, Exec VA, CBI Helpline, Call Center Portals, and Reports of Contact while managing relationships across business units.
Reviews files and records, and discusses with personnel or witnesses regarding any practice that appears to violate patient's rights or which causes unnecessary discomfort or embarrassment to patients, their families, or the health care facility and reports such findings with recommendations for improvements to the facility Director and/or top management team.
Ensure national VA patient advocacy program requirements are met by collecting, analyzing, and evaluating relevant data, and preparing meaningful reports based on that data. - Evaluates the effectiveness, efficiency, and compliance of Community Care operations and related processes, and develops data-driven recommendations for improvement.
Applies analytical and evaluative methods to assess program performance, identify trends, and recommend enhancements to improve service delivery and patient outcomes.
Serve as an advocate for patients throughout Community Care Service, receiving and addressing complaints and grievances from patients or their representatives.
Provides explanation regarding Veteran eligibility/entitlement to benefits according to the Veterans' Benefit Package and the laws and regulations governing VA authority to authorize payment for care in the community.
Communicate with the Veteran to assist in filing claims and explain what action is needed by the Veteran to support their claims.
Receives telephone calls regarding denied or rejected claims and coordinates with appropriate personnel when additional information is required for further review.
Provides consultative guidance to leadership, staff, and stakeholders regarding patient advocacy issues, program operations, and regulatory requirements.
Interprets and applies Federal laws, VA regulations, policies, and procedures to ensure compliance with the Mission Act and other governing authorities.
Coordinates and reroutes calls appropriately with multiples departments are involved.
Facilitates and follows through to ensure final resolution to the customer.
Performs all 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 through Friday, 8:00am to 4:30pm (Tour may be subject to change based on needs of the facility).

Telework: Not Authorized

Virtual: This is not a virtual position.

Compressed/Flexible: Not Authorized

Position Description/PD#: Program Specialist/PD132990

Relocation/Recruitment Incentives: Not Authorized

Critical Skills Incentive (CSI): Not Authorized

Permanent Change of Station (PCS): Not Authorized

Financial Disclosure Report: Not required

Requirements

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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.
All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
Selective Service Registration is required for males born after 12/31/1959
Physical Requirements: The work required does not inherently include any physical requirements essential for successful job performance that could not otherwise be performed with accommodation or workplace adjustment. A pre-placement physical examination is not required.
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 ( 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)

As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period 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 the Federal service.

Upon completion of your probationary period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 07/03/2026.

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. 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:

You may qualify based on your experience and/or education as described below:

GS-09:

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. Qualifying specialized experience includes providing customer service to patients; assisting patients and staff with resolving problems or complaints; assisting with identifying problem areas and suggesting solutions or alternatives; explaining policies and procedures; keeping accurate records and preparing reports and/or written correspondence. NOTE: Experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. OR,
Education: Successfully completed two (2) years of progressively higher-level graduate education or masters or equivalent graduate degree or LL.B. or J.D., in a related field of the position to be filled. Education at the graduate level must have been obtained in an accredited college or university and must demonstrate the knowledge, skills, and abilities necessary to do the work of this position. NOTE: Transcripts must be submitted with your application materials. Education cannot be credited without documentation. OR,
Combination: Combinations of successfully completed graduate level education (beyond the first year) and specialized experience as described above, to meet the total experience requirements. The education portion must include graduate courses that demonstrate the knowledge, skills, and abilities necessary to do to the work of this position. This 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. Experience must be clearly indicated in your resume.

GS-11:

Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-09 in the normal line of progression for the occupation in the organization. Qualifying specialized experience includes providing customer service to patients and staff with resolving problems or complaints; identifying problem areas and suggesting solutions or alternatives; explaining policies and procedures; keeping accurate records and preparing reports and/or written correspondence; collaborating with facility staff to improve the patient experience. NOTE: Experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. OR,
Education: Successfully completed three (3) years of progressively higher-level graduate education leading to a Ph.D. degree, or Ph.D., or equivalent doctoral degree in the related field of the position to be filled. The education portion must include courses that 4/30/2026 10:13 EDT Page 4 of 7 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: Combinations of successfully completed graduate level education (beyond the first 2 years) and specialized experience as described above to meet total experience requirements. The education portion must include graduate courses that demonstrate the knowledge, skills, and abilities necessary to do to the work of this position. NOTE: Transcripts must be submitted with your application materials. Education cannot be credited without documentation. Experience must be clearly indicated in your resume.

Preferred Experience : Experience and knowledge in Community Care programs, including systems used for consultation management such as RefDoc, HSRM, and EPS.

For more information on these qualification standards, please visit the United States Office of Personnel Management's website at

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: 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:

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. 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.

This job opportunity announcement may be used to fill additional vacancies.

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 qualified you must submit appropriate documentation (a copy of the agency notice, your most recent performance rating, and your most recent SF-50 noting current position, grade level, and duty location) and be found well-qualified for this vacancy. To be well-qualified: applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the required competencies of the job. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website at

Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.

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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.

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Eligibility 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.

About the Company

Veterans Health Administration

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