Supervisory Health System Specialist (Credentialing & Privileging Manager)

Veterans Health Administration • Cleveland, OH

7d • Hybrid

About The Position

The Supervisory Health Systems Specialist - Credentialing and Privileging Manager oversees all functions related to healthcare providers' professional credentials, supporting all divisions of the Cleveland VA Medical Center (VAMC). This role involves direct technical and administrative supervision of employees in the Credentialing & Privileging Office, managing staff performance, assessing staffing needs, and planning work. The manager is responsible for developing, modifying, and interpreting performance standards, outlining performance expectations, and providing advice and counsel to staff. They identify and arrange for employee development and training needs. Additionally, the role provides consulting and guidance to local leadership and credentialing employees on all credentialing program matters. The manager attends committee meetings, presents provider credentials, clinical practice histories, and red flags, and serves as the subject matter expert for credentialing updates to Human Resources, providers, and hiring services. They also attend meetings, conferences, and seminars to identify areas for improvement, interpret and explain new regulatory requirements, procedures, and processes, and review clinical privileges and scope of practices for accuracy and compliance. The position ensures all mandatory reviews and recommendations are documented in an electronic credentialing database, leads external and internal regulatory and accrediting investigations, and assists in developing and recommending workflow improvements. The manager is responsible for reporting needs to the State Licensing Board, National Practitioner Data Bank (NPDB), tort claims, and other governing bodies.

Requirements

• Must be a U.S. Citizen to apply for this job.
• 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.
• 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.
• 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-12 position you must have served 52 weeks at the GS-11.
• An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials.
• Applicants must be eligible under the VA Interchange Agreement, having served continuously for at least one year in the other merit system under this interchange agreement.
• All Title 38 Veterans Canteen Service (VCS) employees must have served in their Excepted Service position for at least 90 days in order to be eligible for a position within the Competitive Service.
• Applicants who were previously selected under a Competitive Delegating Examining Office (DEO) announcement must have served in their position for at least 90 days prior to being eligible for other positions within the Competitive Service.
• Undergraduate and Graduate Level 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.
• OR Special Provision for Inservice Placement: Successful completion of an agency-sponsored on-the-job training program may be substituted for qualifying experience, provided it included a formal individualized training plan.
• GS-12 Specialized Experience: You must have at least one (1) full year of specialized experience equivalent to at least the next lower grade level (GS-11) in the Federal Service, that is directly related to the work of the position and has equipped you with the particular knowledge, skills and abilities to successfully perform the duties as a Health System Specialist.
• Qualifying specialized experience is defined as progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care field.
• 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: (1) Missions, organizations, programs, and requirements of health care delivery systems; (2) Regulations and standards of various regulatory and credentialing groups; and (3) Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement.
• At this level, applicants would have obtained this experience working within a health care setting, working directly with clinicians and local leadership to solve problems in support of the delivery of patient care; applying organizational and system-wide strategies for continuous quality improvement; and experience running and supervising an administrative component of a health care credentialing and privileging program.
• Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment.
• 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.
• 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.

Nice To Haves

• Relocation/Recruitment incentive may be authorized for highly qualified candidates.

Responsibilities

• Provides direct technical and administrative supervision to employees in the Credentialing & Privileging Office.
• Manages staff performance by setting and adjusting short and long-term priorities; assesses staffing needs; plans work to be accomplished.
• Develops, modifies, and/or interprets performance standards; outlines and explains performance expectations to staff.
• Provides advice, counsel, and instruction to employees on work and administrative matters.
• Identifies developmental and training needs of employees and provides/arranges for needed development and training.
• Provides consulting and guidance to local leadership and credentialing employees on all matters pertaining to credentialing program.
• Attends committee meetings and presents providers' credentials, clinical practice histories and red flags.
• Performs as the subject matter expert for credentialing updates to Human Resources, providers and hiring services.
• Attends meetings, conferences and seminars to assist with the identification of areas needing improvement.
• Interprets and explains new regulatory requirements, procedures and processes.
• Reviews clinical privileges and scope of practices for accuracy, setting specific indicators and signature appropriations as required for compliance.
• Ensures all mandatory reviews and recommendations are documented in an electronic credentialing database.
• Leads external and internal regulatory and accrediting investigations issues surrounding credentialing, privileging, and/or reporting.
• Assisting with developing, coordinating and recommending changes for the improvement of workflow in the program or section area.
• Responsible for reporting needs to State Licensing Board, National Practitioner Data Bank (NPDB), tort claim, and other governing bodies.

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.
• Contact the hiring agency for more information on the specific benefits offered.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager