This position reports to the Data Integration & Optimization Manager, within the Clinical Operations Service. The Incumbent is responsible for overall program management for the clinic maintenance process for the Facility and leads the facility's efforts to integrate profile management among healthcare providers, other facility staff, and patients. The clinic/provider profiles set up the clinic structure, allowing the scheduling of patients, direct workload capture, direct insurance and co-pay billing, direct MCA costing, and track facility and provider performance against national, Veterans Integrated Network (VISN), and local measures. The incumbent interprets national policies and procedures, developing and implementing local standards, defining requirements and providing advice to top management on related issues pertaining to clinic/provider profile management. Ensures that completed profiles reflect national, network and local goals, directives, and policies. Integrates advanced clinic access (ACA) principles and initiatives, outpatient scheduling directive mandates, ambulatory data capture and workload rules and regulations, coding and billing criteria, MCA requirements into clinic structures.
- Monitors and conducts annual reviews of accuracy of clinic profiles to ensure facility is capturing and transmitting workload accurately for maximum reimbursement, and workload credit.
- Works with services to monitor grid validation, appropriateness of Managerial Cost Accounting (MCA formerly DSS) identifiers, and count/non-count clinics, trains develops, coordinates and provides training to all areas impacting profile management and trains other staff to perform similar duties and will delegate duties, as needed.
- Coordinates all administrative needs of clinic profile building and maintenance, establishing the program goals, evaluating implementation, and data capture components for the Facility.
- Facilitates efficient and effective communication between Program Analysts (ADPAC)s, MCA, encounter form specialists, billing specialists, and assigned service.
- Participates in Facility/VISN projects, task forces, and committees to problem-solve, educate and implement software, data capture and scheduling directive matters, and other workgroups related to access, wait times, and clinic profile management.
- Represents the Facility at forums, conferences, and meetings. Delivers presentations to all levels of the Facility, service organizations, Veterans, family members and caregivers.
- Performs data retrieval and analysis for reports; prepares Facility reports to monitor accuracy and utilization regarding clinic profile management and communicates to appropriate Facility groups for action.
- Assumes overall responsibility for establishing and editing clinic changes, notifications, for new and established clinics and inactivating clinics in the system.
- Coordinates with informatics for development and management of data systems.
- Identifies problems and applies analytical techniques, correcting negative trends and provides resolutions to system issues/malfunctions, to include encounter and transmission errors, clinic grids and other issues related to clinic profile management.
- Updates and maintains digital workflow, forms, designs, and electronic records of clinic maintenance requests, such as creating new, modifications, inactivations and cancellations.
- Investigates complaints from internal and external customers related to clinic profile set up and resolves the complaint or escalates to the appropriate manager.
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.
This position involves a multi-grade career ladder. The major duties listed above represent the full performance level of GS-11. At the GS-09 grade level, you will perform assignments of a more limited scope and with less independence. You will progressively acquire the background necessary to perform at the full performance level of GS-11.
Work Schedule: Monday - Friday 7:30 a.m. - 4:00 p.m.
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 is 100% telework.
Virtual: This is not a virtual position.
Position Description/PD#: Program Analyst (Clinic Profile Manager)
/PD99898-S
Relocation/Recruitment Incentives: Not Authorized
Critical Skills Incentive (CSI): Not Authorized
Starting at $59,966 Per Year (GS 9-11)