U.S. Department of Health & Human Services
Purchase Referred Care (PRC) Office Administrator
Nespelem, WA
Aug 30, 2024
unknown
Full Job Description

Summary

Oversees a for a health care center on the Confederated Tribes of the Colville Indian Reservation. The program assists patients in funding health needs beyond that available at the center. Work includes analyzing effectiveness of program, ensure available funding, regular reports and supervise others who pay claims.

This job announcement is OPEN UNTIL FILLED. Job announcement closes once the position is filled.

Recruitment or relocation incentives may be paid.

Duties

Visit the for information on the Indian Health Service Agency special funding program called Purchasing/Referral Care (PRC). The website provides information to American Indian/Alaska Native (AI/AN) patients on the PRC program requirements for medical/dental care.

Major duties of the Purchase, Referred Care Office (PRC) Administrator:

  • Develop management systems to provide effective and appropriate complex paperwork systems necessary to process thousands of individual cases in accordance changing requirements.
  • Supervises the PRC program staff.
  • Provides to the Chief Executive Officer or Deputy Chief Executive Officer and the PRC Committee a weekly spending plan.
  • Responsible for the sound fiscal management of the PRC Program.
  • Makes determinations and develops policies regarding the extent of service unit participating in costs of medical care for authorized clients.
  • Develops for submission any potential Catastrophic Health Emergency Fund cases.
  • Carries out necessary work to ensure the maximum utilization of alternate resources for major and non-routine cases.
  • Makes efforts to develop other programs and locate other resources to fill unmet health needs due to limitations of the PRC funding.
  • Works with others in development and operation of a variety of health service contracts with local hospitals, clinics, individual consultants, pharmacies, locum agencies to maximize the service and cost effectiveness of health services.
  • Interprets the PRC Program to patients/consumers, partners, and vendors in accordance with appropriate laws, regulations and policies.
  • Trains or meets on regular basis with participating health care providers.
  • Formulates service unit budget requests for contract services. Provide data for the CSU budget formation for the Governing Board.
  • Identifies significant deviations from the approved IHS National and PAO direction projected plans, complies supportive data; revises budgetary requirements and writes requests for budget adjustments for the review and formal presentation to the CEO when supplemental funds are required.
  • Participates on national committees to remain current on the PRC program operations.

Requirements

Conditions of Employment

Selectee may be subject to a probationary period
U.S. Citizenship is required
Selective Service Registration is required for males born after 12/31/1959

This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children. Due to this requirement, the agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes.

Measles and Rubella immunization required for selectees born after 1957 and seasonal influenza immunization is required for all staff working in Indian Health Service health care facilities.

COVID-19 vaccination is required for all selectees prior to entrance on duty.

The selected individual is required to obtain and maintain medical staff clinical privileges, including any licensure requirements. If privileges are not obtained or maintained during employment, the employee will be subject to adverse actions, up to and including removal from Federal service.

Successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit .

You will need to set up direct deposit so we can pay you.

Background Investigation: If you are selected for this vacancy, you must undergo a pre-employment fingerprint check and background investigation. Fingerprint results and background investigation documentation must be cleared prior to hire. After you begin your employment, your continued employment is contingent upon the outcome of a complete background investigation as determined by the sensitivity level of your position. The investigation must find that you are suitable for Federal employment in your position. If you are found not suitable, you will be terminated after you begin work. If you make a false statement in any part of your application, you may not be hired; you may be fired after you begin work; or subject to possible criminal charges. You may be subject to a credit check as a part of the background investigation process.

Qualifications

To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying.

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; religious; spiritual; community; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week.

MINIMUM QUALIFICATIONS FOR GS-11:
  • Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the grade GS-09, which is the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks such as: work experience in managing a program that includes the accounting of money accounts reporting and maintenance, and the processing of claims for the government health facility or private health insurance group.OR
  • Submit a copy of unofficial transcripts to show completed a Ph.D. or equivalent doctoral degree or 3 full years of progressively higher-level graduate education leading to such a degree or LL.M., if related. Such education must demonstrate the knowledge, skills, and abilities necessary to do the work. OR
  • Demonstrate meeting qualifications for this grade level by indicating on resume and submitting a copy of unofficial transcripts to show a combination of specialized experience and graduate level education that meets 100% of the qualification requirements for this position.
Specialized Experience: Experience that equipped the applicant with the particular knowledge, skills, and abilities to perform successfully the duties of the position, and that is typically in or related to the work of the position to be filled.

You must meet all qualification requirements within 30 days of the cut-off date or the closing date of the announcement. The first cutoff date is 10 days after the opening date. If necessary, additional cutoff dates will be established until the position is filled. Once the position is filled, the job announcement closes.

How You Will Be Evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

If you meet the minimum qualifications requirements for this position, your application will be evaluated and rated under Category Rating selection procedures. Once the application process is complete, a review of your qualifications will be conducted to determine if you are qualified for this job. Qualified candidates will be assigned to a quality category. The quality categories are: Best Qualified, Well Qualified, or Qualified. Within each of these categories, applicants eligible for veteran's preference will receive selection priority over non-preference eligibles.

Please note that if, after reviewing your resume and or supporting documentation, a determination is made that you have inflated your qualifications and or experience, your category rating can and will be adjusted to more accurately reflect your abilities, or you may lose consideration for this position. Please follow all instructions carefully. Errors or omissions may affect your eligibility.

To determine if you are qualified for this position, a review of your resume and supporting documentation will be made and compared against the qualifications as defined in the qualifications section of this vacancy announcement and your responses to the assessment questions. You will be rated based on the information provided in your resume (your resume must state specific duties that relate to this position) and your responses to the assessment questions will be evaluated against the duties you provided in your resume, along with your submitted documentation to determine your ability to demonstrate the following.

  • Financial Analysis
  • Financial Management
  • Health Claims Processor
  • Manages Human Resources
  • Planning and Evaluating
  • Technology Application


The following links below provide information on how you may be eligible for various hiring authorities. If you are a Veteran, qualified CTAP and ICTAP eligible, or an individual with a disability, please refer to the following links below for additional guidance. CTAP and ICTAP candidates will be eligible for selection priority if it is determined that they have exceeded the minimum qualifications for the position by attaining at least a "well qualified" rating of 85 out of 100. Information about CTAP and ICTAP eligibility is on the Office of Personnel Management's Workforce Restructuring Career Transition website at: . CTAP/ICTAP documentation requirements are listed in the "Required Documents" section of this announcement.
  • Veterans, i.e. (VEOA, VRA, and 30% or more disabled) -
  • Career Transition Assistance Program (CTAP) -
  • Interagency Transition Assistance Program (ICTAP) -
  • Schedule A Appointments for the Disabled -

Click here to view vacancy questions: . All documents above MUST be received by 11:59 pm (Eastern Standard Time) of the cut-off date or the closing date of, 12/31/2024, to be considered. The first cutoff date is 10 days after the opening date. If necessary, additional cutoff dates will be established until the position is filled.

Required Documents

Resume: You are highly encouraged to use to ensure all required information is included in your Resume. If you use your own resume, curriculum vitae, or any other written form you choose then you must describe your job-related qualifications that includes

  • beginning and ending dates for paid and non-paid work experience,
  • hours worked per week,
  • month and year of employment for each job title listed,
  • description of job duties.
  • Include name and address of employer, supervisor name and telephone number.

Required as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements:
  • Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only." Indian preference will not be given unless a properly signed and dated form is submitted with your application, including any verification by an authorized Tribal Representative or BIA Official of tribal enrollment records. For detailed instructions, see form BIA-4432. Refer to BIA-4432 link: . When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference.
  • Veterans Preference: If claiming Veteran's Preference provide a copy of your DD214 Form (Member 4 copy). To claim 10-Point Veterans Preference, submit a SF-15 Application () along with the appropriate supporting documentation. For additional information regarding Veterans Preference visit: .
  • Career Transition Assistance Program (CTAP)/Interagency Career Transition Assistance Program (ICTAP): If you are claiming CTAP/ICTAP, follow the instructions below: .
  • Transcripts: You are encouraged to submit copies of transcripts (official or unofficial) although not required at the time of application. You must list your courses including titles, credit hours completed, and grades. Official transcripts will be required after tentative selection and prior to issuing an official job offer.
  • Licensure, Certifications: Applicants should list their license/certifications on their resume, along with the expiration date, if applicable. Certification of licensure/certification will be required after tentative selection and prior to issuing an official job offer.

You must meet the requirements of the job by 11:59 (Eastern Standard Time) of the cut off date or the closing date: 12/31/2024

The first Cut-off date for receipt/referral of applications to be considered for available vacant positions will be 10 days after the JOA open date. If necessary, additional cutoff dates will be established until the position is filled.

Your resume and any documents submitted will be retained for three months and may be used at any time during this period. After 3 months, you must reapply to this announcement in order to be considered.

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Purchase Referred Care (PRC) Office Administrator
U.S. Department of Health & Human Services
Nespelem, WA
Aug 30, 2024
unknown
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