HEALTH SYSTEM SPECIALIST

Summary

Click on "Learn more about this agency" button below to view Eligibilities being considered and other IMPORTANT information. The primary purpose of this position is to serve as a TRICARE Health Plan subject matter expert and advocate in support of active duty Exceptional Family Member Program (EFMP) enrolled families.

Duties

• Healthcare Plan Subject Matter Expert. Healthcare Plan Family Advocate. Uses a variety of databases and data reports such as Knowledge Exchange, TRICARE On-Line, TRICARE.mil, Share Point, Managed Care Support Contractors Data Sites, Defense Enrollment Eligibility Reporting System (DEERS), Composite Health Care System/Armed Forces Health Longitudinal Technology Application (CHCS/AHLTA), MHE GENESIS, TRICARE Operations Center (TOC), as well as HR case management systems, to analyze data and construct fact-based data driven information and recommendations for the AF EAP Division and Medical Operations Branch.

Qualifications

In order to qualify, you must meet the specialized experience requirements described in the Office of Personnel Management (OPM) Qualification Standards for General Schedule Positions, Administrative and Management Positions, GS-0671 series. SPECIALIZED EXPERIENCE: I have one year of specialized experience equivalent to the GS-11 grade level in the Federal service. Specialized experience must include: Comprehensive knowledge of the missions, programs and requirements of integrated healthcare delivery systems to include regulations, standards, procedures, methods, and techniques to be applied in the DoD and civilian sector. Knowledge of healthcare issues, program goals/objectives and medical administrative procedures to plan, schedule and conduct projects and studies to evaluate and recommend ways to improve the effectiveness/efficiency of health care delivery to exceptional family members. Knowledge of management and organizational principles and practices and comprehensive knowledge of those practices into the healthcare service field. Knowledge of patient administration departmental procedures, medical treatment facility management policies, and familiarity with general principles of health care administration. Knowledge of benefits authorized by public law and regulations, to included knowledge of the TRICARE health plan and contracts. Knowledge of medical records policies and procedures, and understanding of healthcare related privacy laws and policies. Knowledge and skills in statistics, data analysis, and economic principles to apply various methods and techniques for analyzing data for trends, variances and productivity to identify deficiencies to determine effect and impact on AF health plans management and provide consultations to other AF medical staff. Knowledge of and ability to use information management software such as Microsoft Office products, to include Excel. FEDERAL TIME-IN-GRADE (TIG) REQUIREMENT FOR GENERAL SCHEDULE (GS) POSITIONS: Merit promotion applicants must meet applicable time-in-grade requirements to be considered eligible. One year at the GS-11 level is required to meet the time-in-grade requirements for the GS-12 level. TIG applies if you are in a current GS position or held a GS position within the previous 52 weeks. NOTE: Applicants applying as VEOA candidates who are current GS civil service employees or are prior GS civil service employees within the past 52 weeks must also meet time-in-grade requirements. KNOWLEDGE, SKILLS AND ABILITIES (KSAs): Your qualifications will be evaluated on the basis of your level of knowledge, skills, abilities and/or competencies in the following areas: 1. Comprehensive knowledge of the missions, programs and requirements of integrated healthcare delivery systems to include regulations, standards, procedures, methods, and techniques to be applied in the DoD and civilian sector. Knowledge of healthcare issues, program goals/objectives and medical administrative procedures to plan, schedule and conduct projects and studies to evaluate and recommend ways to improve the effectiveness/efficiency of health care delivery to exceptional family members. 2. Knowledge of management and organizational principles and practices and comprehensive knowledge of those practices into the healthcare service field. 3. Knowledge of patient administration departmental procedures, medical treatment facility management policies, and familiarity with general principles of health care administration. Knowledge of benefits authorized by public law and regulations, to included knowledge of the TRICARE health plan and contracts. Knowledge of medical records policies and procedures, and understanding of healthcare related privacy laws and policies. 4. Knowledge and skills in statistics, data analysis, and economic principles to apply various methods and techniques for analyzing data for trends, variances and productivity to identify deficiencies to determine effect and impact on AF health p…

Education

IF USING EDUCATION TO QUALIFY: If position has a positive degree requirement or education forms the basis for qualifications, you MUST submit transcripts with the application. Official transcripts are not required at the time of application; however, if position has a positive degree requirement, qualifying based on education alone or in combination with experience, transcripts must be verified prior to appointment. An accrediting institution recognized by the U.S. Department of Education must accredit education. Click here to check accreditation. FOREIGN EDUCATION: Education completed in foreign colleges or universities may be used to meet the requirements. You must show proof the education credentials have been deemed to be at least equivalent to that gained in conventional U.S. education program. It is your responsibility to provide such evidence when applying.