Summary
This position is in the Civilian Health and Medical Program-VA (CHAMPVA), Veteran and Family Member Programs (VFMP) Directorate, Office of Integrated Veteran Care (IVC), Veterans Health Administration (VHA), Department of Veterans Affairs (VA). The position is organizationally aligned under the Chief, CHAMPVA. The primary function of these positions is to provide care coordination support on behalf of beneficiaries enrolled in CHAMPVA Programs.
Duties
The position requires skill in applying analytical and evaluative techniques to the identification, consideration, and resolution of issues or problems of a procedural or factual nature. Recognizes when available data is insufficient to support a conclusion and identifies what additional information is needed. The employee plans, coordinates, and carries out the successive steps in fact-finding and analysis of issues necessary to complete each phase of assigned projects. Anticipates how a proposed change will be received by different audiences and adjusts the framing, sequencing, or content accordingly Builds and sustains comprehensive communication channels via social media and other publicly accessible digital collaboration platforms. Weighs the feasibility of recommendations against resource constraints, staffing realities, and political/organizational dynamics Assists local case management providers and beneficiaries to explain claim processing errors, delays or other problems regarding benefits, pre-authorizations for care and other authorized service activities. Regularly interacts with customers - clinical chiefs, community partners, Veterans' families, VISN program managers - who may be frustrated, skeptical, or adversarial. Effective customer service at this level means de-escalating tension, maintaining professional credibility, and preserving the working relationship even when the interaction is uncomfortable. Facilitates outreach to beneficiaries via email, phone, teleconference or standard letters. Independently provides routine updates to providers and beneficiaries on available services and current policies. Communicates proactively when timelines, outputs, or circumstances change - does not wait for the customer to notice a problem Conducts phone interviews with program beneficiaries, health care providers and other authorized third-party contacts to assist with eligibility issues and healthcare services appropriate to beneficiary needs. Must independently make decisions about how CHAMPVA care coordination programs are structured, how limited resources are allocated across competing program needs, and which program components to prioritize when everything cannot be done simultaneously. Distinguishes between stakeholder input that should change the decision and stakeholder pressure that should not. Must ensure that care coordination programs are not just operationally sound but strategically positioned - aligned with VHA's strategic plan, VISN priorities, facility leadership objectives, and emerging national program emphases Identifies where current care coordination programs are misaligned with emerging organizational priorities and proactively proposes realignment before leadership identifies the gap Work Schedule: Monday through Friday 8:00am to 4:30 pm Compressed/Flexible: Available Telework: This position may be authorized for ad hoc telework. Telework eligibility will be discussed during the interview process. Ad hoc is defined as occasional, non-recurring telework Virtual: This position may be authorized for Virtual Work. Virtual Work eligibility is for current VA employees that are already subject to the return to the in-person work mandate in their current position. Definition of Virtual Work: Employee works outside of original hiring duty station at a VA-owned or leased space. Return to Office (RTO): RTO mandates are in effect and selectees will be required to report to in-person work unless they are approved for an exception or an exemption. Any approval for an RTO exception, exemption, or extension will happen after a tentative job offer, but before a final job offer. Position Description/PD#: Health System Specialist/PD68675A and PD68674A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized
Requirements
You must be a U.S. Citizen to apply for this job To be considered for this position, you must complete all required steps in the process. In addition to the application and questionnaire, this position requires an online assessment. The online assessment measures critical general competencies required to perform the job. Physical Requirements: The work required does not inherently include any physical requirements essential for successful job performance that could not otherwise be performed with accommodation or workplace adjustment. A pre-placement physical examination is not required. Subject to background/security investigation Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). 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. In determining if your employment advances the public interest, we may consider: your performance and conduct; the needs and interests of the agency; whether your continued employment would advance organizational goals of the agency or the Government; and whether your continued employment would advance the efficiency of the Federal service. Upon completion of your probationary period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.
Education
A transcript must be submitted with your application if you are basing all or part of your qualifications on education. Note: 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. You can verify your education here: http://ope.ed.gov/accreditation/. 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. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.
How you will be evaluated
Your qualifications will be evaluated based on your application materials (e.g., resume, supporting documents), your responses on the application questionnaire, and your responses to all assessments required for this position. You will be assessed on the following Competencies for this position: Attention to Detail Customer Service Decision Making Flexibility Integrity/Honesty Interpersonal Skills Learning Reading Comprehension Reasoning Self-Management Stress Tolerance Teamwork Your experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. 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. IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Overstating your qualifications and/or experience in your application materials or application questionnaire may result in your removal from consideration. Cheating on the online assessment may also result in your removal from consideration. 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; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions.