Program Support Assistant

Veterans Health Administration • North Chicago, IL

31d • Hybrid

About The Position

The Captain James A. Lovell Federal Health Care Center (FHCC) in North Chicago, Illinois is a VA and DoD dually integrated healthcare center providing care services to Veterans, Active-Duty Military Personnel, and their beneficiaries, including outpatient pediatric services. The primary purpose of this position is to serve as an Office of Community Care (OCC) Coordinator. The incumbent provides administrative care coordination support to clinicians and other administrative and/or professional staff for purposes of coordinating Non-VA medical care for veterans when inpatient and outpatient, and their VA provider has deemed such care necessary. The OCC program requires administrative scheduling and appointment coordination for diagnostic testing, and referral appointments for many clinical services. This position is responsible for checking eligibility determination for Non-VA medical care in accordance with the MISSION Act, for generating authorizations of pre-authorized medical care. Works closely with the Community Care Nurse Coordinator to ensure proper authorizations are issued, and appropriate correspondence are sent to vendors. Incumbent acts as a liaison between the veteran and the vendors with regard to OCC section and VA clinical services and/or primary care services. Obtains requested medical records including reports, x-rays, labs, and any pertinent information required to complete referrals in the Federal Electronic Health Record (FEHR) or applicable software system. Ensures all necessary components and documentation are distributed to appropriate services at the private institution where service will be provided. Collaborates with OCC nurse to prioritize requested procedure based on urgency (stat and routine), combat veteran status and compensation and pension exams in accordance with policy. The incumbent is responsible for the coordination of all administrative information between the professional staff and veterans. This includes updating and verifying demographic information, data entry, administratively managing referral requests, making and notifying the patient of his/her scheduled appointment with the outside provider(s). The incumbent is responsible for generating correspondence to the veterans and various providers and managing all received correspondence related to care. The incumbent appropriately processes authorizations based on eligibility. Performs assignments involving different processes, complexity, or methods in varying sequence. Applies policies and procedures in resolving non-recurring problems. The incumbent reviews and determines veteran's eligibility for specialty programs in the VA Community Care Program and appropriately processes their authorization. He/She discusses eligibility for programs or specific claims with vendors, veterans, and/or service officers. Serves as the point of contact for designated community care claim needs, providing information for Payment Operation and Management when authorizations are required for outstanding claims. Ensures the community care network is appropriate for selection and including timely scheduling. Explains the VA's mandate to collect insurance information to veterans, their families, and other eligible patients.

Requirements

• Must be a U.S. Citizen to apply.
• Must complete all required steps in the process, including application, questionnaire, and online assessment.
• Selective Service Registration is required for males born after 12/31/1959.
• Subject to background/security investigation.
• Selected applicants will be required to complete an online onboarding process.
• Acceptable forms of identification will be required to complete pre-employment requirements.
• Participation in the seasonal influenza vaccination program is a requirement.
• Must serve a 1-year probationary period.
• To qualify for GS-5: One year of specialized experience equivalent to at least the GS-4 level, or a full 4-year course of study above high school leading to a bachelor's degree, or a combination of education and experience.
• Specialized experience for GS-5 includes: Strong communication and interpersonal skills to coordinate with staff across clinical and administrative areas. Detailed knowledge of privacy, confidentiality, and data protection laws including HIPAA, the Privacy Act, and VA information security policies. Familiarity with VA performance improvement principles, safety practices, infection control standards, and equipment use in a healthcare setting. Coordinate meeting logistics, prepare agendas, manage correspondence, and maintain time-sensitive documents with minimal supervision.
• To qualify for GS-6: At least one full year of specialized experience at the GS-5 level.
• Specialized experience for GS-6 includes: Strong communication and interpersonal skills to coordinate with staff across clinical and administrative areas. Detailed knowledge of privacy, confidentiality, and data protection laws including HIPAA, the Privacy Act, and VA information security policies. Familiarity with VA performance improvement principles, safety practices, infection control standards, and equipment use in a healthcare setting. Coordinate meeting logistics, prepare agendas, manage correspondence, and maintain time-sensitive documents with minimal supervision. Proficiency in Microsoft Office (Excel, Word, Outlook), SharePoint, and VA systems such as VistA, VATAS, BMS, and HR Smart, with the ability to extract and compile operational data. Working with scheduling systems, time and leave policies for Title 5 and Title 38 employees, and the ability to reconcile complex schedules with varied tours, pay entitlements, and leave statuses. Data entry, document formatting, proofreading, and written communication using VA standards and terminology.
• 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-6 position, you must have served 52 weeks at the GS-5 level.

Nice To Haves

• The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met.

Responsibilities

• Serve as an Office of Community Care (OCC) Coordinator.
• Provide administrative care coordination support to clinicians and other staff for coordinating Non-VA medical care for veterans.
• Perform administrative scheduling and appointment coordination for diagnostic testing and referral appointments.
• Check eligibility determination for Non-VA medical care in accordance with the MISSION Act.
• Generate authorizations of pre-authorized medical care.
• Work closely with the Community Care Nurse Coordinator to ensure proper authorizations are issued and appropriate correspondence is sent to vendors.
• Act as a liaison between the veteran and vendors regarding OCC section and VA clinical services.
• Obtain requested medical records and pertinent information for referrals.
• Ensure necessary components and documentation are distributed to appropriate services at private institutions.
• Collaborate with OCC nurse to prioritize requested procedures based on urgency, combat veteran status, and compensation and pension exams.
• Coordinate all administrative information between professional staff and veterans.
• Update and verify demographic information.
• Perform data entry and administratively manage referral requests.
• Notify patients of scheduled appointments with outside providers.
• Generate correspondence to veterans and providers and manage received correspondence.
• Appropriately process authorizations based on eligibility.
• Perform assignments involving different processes, complexity, or methods in varying sequence.
• Apply policies and procedures in resolving non-recurring problems.
• Review and determine veteran's eligibility for specialty programs in the VA Community Care Program and process authorizations.
• Discuss eligibility for programs or specific claims with vendors, veterans, and/or service officers.
• Serve as the point of contact for designated community care claim needs, providing information for Payment Operation and Management.
• Ensure the community care network is appropriate for selection and timely scheduling.
• Explain the VA's mandate to collect insurance information to veterans, their families, and other eligible patients.

Benefits

• 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.
• Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree