Clarification from the agency

This position is Open to all U.S. citizens. NOTE: The 2-page Resume requirement does not apply to this occupational series. For more information, refer to the Required Documents below.

The Chief Medical Records Administrator is a Registered Health Information Administrator who is charged with full responsibility, both technical and administrative, for the daily operation of the Health Information Management Section, which consists of all functions of medical record activities related to coding, analyzing, and release of information, transcription, file room, and scanning programs.

Provides expertise, guidance, and direction and has responsibilities relative to providing supervision, administrative support, coordination, and technical assistance in the planning, development, and maintenance of an effective, comprehensive, and integrated HIM Program at this Medical Center.

FUNCTIONS:

1. Provides technical and managerial expertise relative to health information management. This includes recommendations regarding organizational structure, workflow, section policy, interpretation of section objectives, and methods of staffing within the section. Implements recommendations and exercises immediate supervisory authority over the Coding Unit, File/Scanning unit, and Release of Information Unit. Has knowledge of statistics to assess patient workload and establish quality controls.
2. Evaluates Patient Treatment File PTF data validation program to include a qualitative review and evaluation of the clinical as well as administrative information reported into the PTF system, with analysis and recommendations for corrective action. Responsible for the timely and complete submission of all quarterly census patients and for the PTF abstracts, which have a monthly close-out date with an annual hard close-out date for the fiscal year to the Austin Automation Center AAC National Patient Care Database NPCD.
3. Advises Medical Record Technicians (MRT) in problem areas about quantitative and qualitative analysis of medical records and determines the acceptability of content. Consults with physicians and other clinicians regarding record deficiencies as appropriate.
4. Coordinates and updates the Quality Management program for HIMS. Joint Commission and VA standards require a quality management program, which includes medical record audits based on input from the Medical Records Committee, quality improvement staff, and medical staff. Audits will consist of review files. Develops and maintains collaborative relationships with Physicians, Service Chiefs, and other medical center staff at all organizational levels.
5. Additionally, is responsible for determining the need for and extent of training personnel outside HIMS regarding the medical records and its format. May be required to develop training materials and continuing education programs. Training programs developed and conducted by employees may include medical terminology, Evaluation and Management Code assignment, medical record documentation requirements, Release of Information, Privacy Act, and HIPAA instructions. Assistance is also provided in formal and informal service training and orientation of house staff, as well as other members of the health care team, regarding medical record functions and quality content.
6. Responsible for assisting physicians and other health professionals in obtaining medical record information to be used in research projects. Advises on what material is available, how it may be obtained, and the uses that can be made of the information while protecting the confidentiality of the record.
7. Provides technical guidance to the unit supervisors and lead clerks while providing support to each unit in the absence of the section supervisor. Provides expertise in subpoenas, court orders, advance directives, Privacy Act, Freedom of Information Act, and general release of information, as well as other medical and legal issues.
8. Work is of an analytical, evaluative, and creative nature, and the incumbent is responsible for keeping abreast of changes that are constantly being made in the health information field as well as allied medical fields and applying the information and knowledge gathered to the operations of the hospital.

Work Schedule: 07:00 am - 3:30 pm, Monday - Friday
Telework: Not Available
Virtual: This is not a virtual position.
Functional Statement #: 688-25115-F
Relocation/Recruitment Incentives: Not Authorized
Permanent Change of Station (PCS): Not Authorized

Conditions of employment

• You must be a U.S. Citizen to apply for this job.
• Selective Service Registration is required for males born after 12/31/1959.
• Must be proficient in written and spoken English.
• 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).
• Complete all application requirements detailed in the "Required Documents" section of this announcement.

As a condition of employment for accepting this position, you will be required to serve a 1 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 the 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 trial period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.

Qualifications

Basic Requirements:

• United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
• Education or Experience:

1. Experience. Three years of [creditable] experience in the field of medical records that included the preparation, maintenance, and management of [health] records and health information systems [demonstrating a knowledge of medical terminology,] medical records [procedures, medical coding, or medical, administrative, and legal requirements of health care delivery] systems. OR,
2. Education. [Successful completion of a bachelor's degree or higher from an accredited college or university [recognized by the U.S. Department of Education, with a major field of study in health information management, or a related degree with a minimum of 24 semester hours in health information management or health information technology.] OR,
3. Experience/Education Combination. Equivalent combinations of [creditable] experience and education that equals 100 percent may be used to meet basic requirements. [For example, two years above high school from an accredited college or university, with 12 semester hours in health information technology/health information management, plus one year and six months of creditable experience that included the preparation, maintenance, and management of health records and health information systems, meets an equivalent combination.

• Certification. Persons hired or reassigned to MRA positions in the GS-0669 series in VHA must meet one of the following:

1. Coding Certification through AHIMA or AAPC. OR
2. HIM Certification through AHIMA. OR
3. Health Data Analyst Certification through AHIMA.

NOTE. HIMs Certification is required for all positions above the full performance level.

• English Language Proficiency. MRAs must be proficient in spoken and written English. See 38 U.S.C. § 7403(f).

Grade Determinations: In addition to the basic requirements for employment, the following criteria must be met when determining the grade of candidates:

Medical Records Administrator (Chief (CHIM)), GS-13
Experience. One year of creditable experience equivalent to the next lower grade level that demonstrates the KSAs described at that level.

• Example of GS-12 Experience: determining and evaluating compliance with legal, ethical, and regulatory guidelines and accrediting bodies, as they apply to health information management. Evaluating, developing, and implementing new policies, procedures, and programs. Provide program oversight, including advisory and technical expertise on a range of health information management practices and guidelines to staff at various levels. Develop and conduct training on health information management programs, policies, procedures, and performance improvement activities. Procure and manage HIM resources (i.e., space, staffing, education, budget, etc.). Provide the full range of supervisory duties to include assignment of work, completing performance evaluations, selection of staff, and recommendation of awards, advancements, and disciplinary actions. Communicate effectively (both written and verbal) and interact with all levels of hospital personnel, physicians, patients, and external agencies. Deal effectively with sensitive and/or complex situations.

AND

• Certification. Employees at this level must have a HIM Certification.

AND

• Demonstrated Knowledge, Skills, and Abilities

1. Ability to determine and evaluate compliance with legal, ethical, and regulatory guidelines and accrediting bodies, as they apply to health information management.
2. Ability to provide sound, technical guidance to staff at various levels about major program, legal, or procedural changes related to health information management.
3. Skill in revising facility policies and procedures to improve health information management services and to evaluate, modify, and/or adapt new methods to meet regulatory requirements.
4. Skill in analyzing complex data, interpreting, and trending results for effective management of the HIM program.
5. Skill in management/administration, which includes program planning, coordination, interpretation, supervision, consultation, negotiation, problem solving, and monitoring of HIM processes.
6. Ability to delegate authority, evaluate and oversee people and programs, accomplish program goals, and adapt to changing priorities.

Assignments. This assignment is the Chief Health Information Management (CHIM), which is the highest-level professional position at the facility with responsibility for the management and direction of the health information management program. This assignment is only for the CHIM in VA Medical Centers for all categories (1a, 1b, and 1c) within the complexity level 1 as designated in the VHA, "2014 Facility Complexity Level Model", with full program management and supervisory responsibility to direct professional MRAs, technical MRTs, and other support staff in health information management. CHIMs in this assignment provide technical advice, planning, and evaluation about health information management issues impacting the overall program on a regular and recurring basis. Multi-division, integrated health care systems under the leadership of a single director are considered to be a single facility with one CHIM. A position with program responsibility over less than a single health care system does not have full program responsibility for the health information management program. The CHIM establishes policies, procedures, responsibilities, and requirements for HIM-related matters, such as health record documentation, coding and clinical documentation improvement, release of information, file room/scanning, records management, transcription, and medical speech recognition, as well as the overall management of health information and Veterans' health records. They oversee development, implementation, and adherence to HIM industry standards, policies, procedures, laws, regulations, and accrediting bodies. They ensure the facility is in compliance with applicable standards by completing HIM audits, developing healthcare data reports, and statistical information for timely and accurate reporting. The CHIM monitors HIM performance through dashboards, productivity standards, and benchmarking. They participate in establishing and implementing strategic facility and HIM Department goals and controlling program activities and cost, budgeting, procurement, and property management, to achieve goals and improve processes. The CHIM monitors and manages HIM workflow to ensure program objectives are met.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

The full performance level of this vacancy is GS-13.

Physical Requirements: See VA Directive and Handbook 5019.

How you will be evaluated

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

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Your application, resume, C.V., and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect consideration for employment.

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, 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.

The Department of Veterans Affairs performs pre-employment reference checks as an assessment method used in the hiring process to verify information provided by a candidate (e.g., on a resume or during an interview or hiring process); gain additional knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position.

It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.

Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members.

To apply for this position, you must provide a complete Application Package which includes:

• Professional Certification
• Resume

Special Note for Applications: To complete your application, please use the following link https://vacareers.va.gov/wp-content/uploads/sites/5/Resume.docx to download the standard Clinical Resume Document. This one-page document does not need to be modified and must be uploaded into the two-page restricted 'Resume' document upload field.

Your full resume/CV may be uploaded without page limitation into the 'Other' document upload field.


The following documents are accepted and may be required if applicable to your eligibility and/or qualifications for this position. Please ensure that you have included all required documents for your application, such as a copy of your transcript (if using education to qualify), SF-50s (for current/former Federal employees), etc.

• Cover Letter
• DD-214/ Statement of Service
• Disability Letter (VA)
• Full resume/CV may be uploaded without page limitation
• Professional Certification
• Resume
• Separation Notice (RIF)
• SF-15
• SF-50/ Notification of Personnel Action
• Transcript

Veterans' Preference: When applying for Federal Jobs, eligible Veterans should claim preference for 5pt (TP), 10pt (CP/CPS/XP), or for Sole Survivor Preference (SSP) in the questionnaire. You must provide a legible copy of your DD214(s), which shows dates and character of service (honorable, general, etc.). If you are currently serving on active duty and expect to be released or discharged within 120 days, you must submit documentation related to your active duty service which reflects the dates of service, character of service (honorable, general, etc.), and dates of impending separation. Additionally, disabled veterans and others eligible for 10-point preference (such as widows or mothers of eligible Veterans) must also submit an SF-15 "Application for 10 Point Veteran Preference" with required proof as stated on the form. Documentation is required to award preference. For more information on Veterans' Preference, please visit Feds Hire Vets - Veterans - Job Seekers - Veterans' Preference.

Veterans' preference does not apply to internal or other current permanent Federal agency employees.

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