Health System Specialist

Description:

This position is located in the Purchased/Referred Care (PRC) Department of the Cass Lake Service Unit (CLSU) in Cass Lake, Minnestoa in the Bemidji Area. The position performs specialist work in the support of the PRC Department.

Requirements:

To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying.

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; religious; spiritual; community; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week.

BASIC REQUIREMENT(S):
Individual Occupational Requirements
Undergraduate and Graduate Education:
Major study -- hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration.

or

Specialized Experience
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.
In addition, to the Basic Requirements, you must also meet the Minimum Qualifications stated below-

MINIMUM QUALIFICATIONS:
Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Providing technical support and assistance to program staff and facility staff on matters involving oversight and management of various services, i.e., medical, surgical, dental and ancillary to eligible beneficiaries; performing high cost case management of expenditures to determine cases that may include catastrophic illnesses; advising and educating beneficiaries on eligibility of services; assisting with monitoring of fund control and appropriate use of dollars spent on allowed services; auditing claims processed for patient eligibility for third party programs ensuring proper codes submitted to cover primary provider, diagnosis and clinic OR a master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree or LL.B. or J.D., if related.

You must meet all qualification requirements within 30 days of the closing date of the announcement.