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Vacancy No. IHS-25-PX12741084-ESEP/MP Department Indian Health Service
Salary $40,332.00 to $83,859.00 Grade 5 to 8
Perm/Temp Permanent FT/PT Full-time
Open Date 5/23/2025 Close Date 5/30/2025
Job Link Apply Online Who may apply Status Candidates
Locations:
Parker, AZPeach Springs, AZPhoenix, AZPolacca, AZ


Summary

This position is located at various locations in the Southwest Region of the Indian Health Service. The purpose of the position is to determine patient's eligibility, defining and interpreting regulations and guidelines and maintaining records. Employee identifies and assists patients who may be eligible for coverage by third party resources. Subject matter expert in determining patient's eligibility and advise others as needed.

Duties

Eligibility Determination:

  • Receives notification and referrals for referred care through hard copy or the automated referred care system. Enters or edits all referrals. Ensures accurate data entry in order to retrieve meaningful reports.
  • Verifies and determines patient's eligibility for Medicare, Medicaid, Private Insurance, VA or other potential alternate resources as appropriate, which are available and accessible to the individual.
  • Develops and implements procedural guides; compiles and interprets various alternate resource references and guides.
  • Researches matters thoroughly based on appropriate regulations or other mandatories prior to rendering work product. Analyzes the facts of individual cases and researches regulations and guidelines, which are relevant to the facts of the case.
  • Determines the sufficiency of the documentation submitted for consideration. Initiates action with appropriate office(s) in order to obtain the required documentation or information (i.e. supportingdocuments and evidence).

Issuance of documents:

  • Ensures that funds are available prior to issuance of obligating documents on behalf of the government.
  • Provides forecasting of weekly document control register balances after each week's obligations have been completed to ensure funds are expended in accordance within spending plans.

Fiscal Management Activities:

  • Maintains complete fund control records for health services funds allotted.
  • Ensures the presence of accurate information, monitors activities and records pertaining to the fiscal management of funds. Identifies problem areas and recommends corrective action.
  • Reconciles the commitment register to the automated financial system.
  • Ensures and maintains internal (Service Unit) fiscal controls by utilizing appropriate fiscal and accounting codes on funds being obligated.


Administrative Support:

  • Issues correspondence to patients, health care providers and other agencies regarding eligibility, policy and regulations, including letters of denial of payment where the requirements of the program are not met.
  • Maintains program files including letters of denials with all backup material for reason for denial, elective procedures, etc.
  • Completes timely response to appeals through review of case files and all supporting information.

Case Management:

  • Tracks all referrals to include those referrals to other facilities to support the Case Management activities and continuity of care efforts.
  • Participates in the weekly Case Management meetings, takes minutes and prepares the minutes for record and reporting purpose.
  • Researches and follow up with facilities on weekly basis for current medical status and costs to determine whether the case will be a Catastrophic Health Emergency Fund (CHEF) case.

Requirements

Conditions of Employment

Must pass pre-employment examination.
Selectee may be subject to a probationary/trial period
ESEP appointees typically serve a two year trial 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.

Confidential Financial Disclosure Form required.

IHS Selectees that will work in an IHS health care facility may be subject to Employee Health Policies related to Measles and Rubella, and seasonal influenza immunizations. Vaccine exemption requests may be available according to the National and/or Service Unit guidance.

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 www.dhs.gov/E-Verify/.

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, GS-0962-05:
Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-04 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Examples include: Assist individuals in completing forms, provide information to the public, conduct personal or telephone interviews by utilizing screening and interviewing methods, verify patient eligibility for benefits, review claims and review records; establish and maintain contact with internal/external entities, local and regional agencies, programs and offices in order to obtain relevant information.

OR

Possess (4) years of education above the high school level. NOTE: One year of full-time academic study is defined as 30 semester hours, 45 quarter hours, or the equivalent in a college or university, or at least 20 hours of classroom instruction per week for approximately 36 weeks in a business, secretarial, or technical school. (TRANSCRIPTS REQUIRED)

OR

Possess a combination of education and experience that when combined fully meet the minimum qualifications for this position. The total percentage must equal at least 100 percent to qualify an applicant for GS-05 grade level. (TRANSCRIPTS REQUIRED)

MINIMUM QUALIFICATIONS, GS-0962-06:
Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Examples include: Assist individuals in completing forms, provide information to the public, conduct personal or telephone interviews by utilizing screening and interviewing methods, verify patient eligibility for benefits, review claims and review records; establish and maintain contact with internal/external entities, local and regional agencies, programs and offices in order to obtain relevant information; monitor pending actions.

MINIMUM QUALIFICATIONS, GS-0962-07:
Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-06 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Examples include: Assist individuals in completing forms, provide information to the public, conduct personal or telephone interviews by utilizing screening and interviewing methods, verify patient eligibility for benefits, review claims, review records, establish and maintain contact with internal/external entities, local and regional agencies, programs and offices in order to obtain relevant information; monitor pending actions, interpret and explain rules and regulations for a variety of alternate resources.

MINIMUM QUALIFICATIONS, GS-0962-08:
Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-07 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Examples include: Assist individuals in completing forms, provide information to the public, conduct personal or telephone interviews by utilizing screening and interviewing methods, verify patient eligibility for benefits, review claims, review records, establish and maintain contact with internal/external entities, local and regional agencies, programs and offices in order to obtain relevant information. monitor pending actions, interpret and explain rules and regulations for a variety of alternate resources, compile and write reports, research records or guidelines; advise individuals on all aspects of benefits.

Time In Grade
Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP).

You must meet all qualification requirements within 30 days of the closing date of the announcement.

Education

If you wish to qualify using education, you MUST submit a copy of your transcripts or a list of your courses including titles, credit hours completed, and grades. Unofficial transcripts will be accepted in the application package. Official transcripts will be required from all selectees prior to receiving an official offer.

Only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education may be credited. Applicants can verify accreditation at the following website: https://www.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/.

Additional information

Additional selection(s) of candidates may be possible within 240 days from the date the certificate of eligibles was issued for this announcement.

Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. IHS may offer newly-appointed Federal employees credit for their directly related previous non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave.

This position is covered by a Bargaining Unit.

Recruitment or relocation incentives may be authorized. At least a (1) year service agreement will be required.

This position may have promotion potential but is dependent on the location of the position and the position description. If there is promotion potential, promotion to the next grade level is at management's discretion and is based on your demonstrated ability to perform the higher level duties, the continuing need for the higher level duties, and "Regulatory/Administrative" approval. Promotion to the next higher grade level is not guaranteed and no promise of promotion is implied. This promotion potential will be reflected in the offer letter for employment.

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. Opens in a new windowLearn more about federal benefits.

Review our benefits

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.

How You Will Be Evaluated

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

Additional selections may be made for similar positions across the Department of Health and Human Services (HHS) within the local commuting area(s) of the location identified in this announcement. By applying, you agree to have your application shared with interested selecting official(s) at HHS. Clearance of CTAP/ICTAP will be applied for similar positions across HHS.

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 further evaluated/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 to determine your competency in the following.

  • Customer Service (Clerical/Technical)
  • Oral Communication
  • Reasoning
  • Technical Competence


You will receive a numeric rating based on your responses to the assessment questionnaires. If after reviewing your resume and responses to the assessment questions, a determination is made that you have overstated your qualifications and or experience, you may lose consideration.

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: https://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/. CTAP/ICTAP documentation requirements are listed in the "Required Documents" section of this announcement. Click here to view vacancy questions: https://apply.usastaffing.gov/ViewQuestionnaire/12741084. All documents above MUST be received by 11:59 pm (Eastern Standard Time) of the closing date of, 05/30/2025, to be considered.

Required Documents

Resume: You are highly encouraged to use USAJOBS Resume Builder 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, annual salary, and 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: https://www.bia.gov/sites/default/files/media_document/1076-0160_indian-pref_expires-04.30.25_508.pdf. 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 (http://www.opm.gov/forms/pdf_fill/SF15.pdf) along with the appropriate supporting documentation. For additional information regarding Veterans Preference visit: http://www.fedshirevets.gov.
Career Transition Assistance Program (CTAP)/Interagency Career Transition Assistance Program (ICTAP): If you are claiming CTAP/ICTAP, follow the instructions below: http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/ctap_guideline.pdf.
Current or former Federal employee: Include your most recent SF-50 or if Reinstatement eligible include your Career SF-50.
Noncompetitive eligibles: Submit additional documents to prove your eligibility to apply to this vacancy.
Transcripts: You must submit transcripts if you are using education to qualify. If not using education to qualify, 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 pm (Eastern Standard Time) of the closing date: 05/30/2025

If you are relying on your education to meet qualification requirements:

Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education.

Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.

How to Apply

To apply for this position, you must provide a complete Application Package. See required documents below.

  1. Click 'Apply' to create an account or log in to your existing USAJOBS account.
  2. Follow the prompts to upload your resume and/or supporting documents.
  3. Read all Eligibility questions and respond accordingly. .
  4. Complete the assessment questions.
  5. Verify all required documentation is included in your application package.
The IHS provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application and hiring process, please notify the Human Resources Office (Chelsea Banteah, chelsea.banteah@ihs.gov, and/or 602-364-5219.) The decision on granting reasonable accommodation will be on a case-by-case basis.

For additional questions please see our Frequently Asked Questions (FAQs) found here: http://www.ihs.gov/jobs/index.cfm?module=search&option=faq.

Agency contact information

Chelsea Banteah
Address
Phoenix Area Indian Health Service
40 North Central Avenue
Phoenix, AZ 85004
US

Next steps

You can track the progress of your application package via your USAJobs account. You will receive an acknowledgement from USAJobs that your submission was successful once we have received your on-line occupational questionnaire, resume, and any supporting documentation. You will be notified of the status of your application via your USAJobs Account after we conduct a qualification review of your complete application package. You will be contacted if further evaluation or interviews are required. Any exaggeration of your experience, false statements, or attempt to conceal information may disqualify you for employment consideration. We may verify all information you provide in your resume and questionnaire responses, through reference and/or background check, and/or verification of your education. If you are selected, you will be contacted personally by the human resources office posting this announcement.

If all required documentation is not submitted with your application you will lose consideration. It is the applicant's responsibility to verify that information and documents entered, uploaded, or faxed are received, legible and accurate. HR will not modify answers submitted by an applicant.

HHS has a critical preparedness and response mission: HHS protects the American people from health threats, researches emerging diseases, and mobilizes public health programs with domestic and international partners. In support of this mission, HHS offers its employees the opportunity to volunteer to become Federal Civilian Detailees and contribute their unique skills through voluntary temporary assignments to humanitarian emergencies or Departmental priorities countering new and emerging health, safety, and security threats.

~ ~ ~ Indian Health Service is an Equal Opportunity Employer ~ ~ ~

Additional Locations

  • Supai, AZ
  • Whiteriver, AZ
  • Winterhaven, CA


Note: We cannot accept applications on behalf of Federal Agencies. Application instructions are listed within the Job Description.


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