Clarification from the agency

The IHS is required by law to give absolute preference to qualified applicants who meet the Secretary of the Interior's definition of Indian for appointment to vacancies within the IHS in accordance with established IHS policy as outlined in the Indian Health Manual Part 7, Chapter 3.

• Apply and interpret federal, state, Tribal, and private-sector regulations to determine patient eligibility and funding for healthcare programs.
• Analyze medical, financial, and eligibility documentation to resolve complex benefit, authorization, and coverage issues.
• Issue medical authorizations or denial determinations and coordinate with patients, providers, and agencies to support continuity of care.
• Maintain fund control records, monitor expenditures, apply accounting codes, and resolve program or funding discrepancies.
• Compile and analyze reports related to program operations, funding, and utilization.

Conditions of employment

Selectee may be subject to a probationary 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.

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/.

Selectee(s) must maintain an active bank account with a financial institution to receive salary payments through electronic direct deposit.

Background Investigation Requirement:

This position requires the successful completion of a federal background investigation as a condition of employment.

A background investigation is a standard process used by the Federal Government to verify an individual's identity, employment history, education, and other relevant information to determine suitability for Federal service.

Upon receipt of instructions, applicants must complete all required background investigation forms within five (5) calendar days of issuance. Timely completion is critical to avoid delays in processing or a determination of unsuitability.

Applicants are strongly encouraged to prioritize this requirement and to maintain regular communication with their assigned Personnel Security Specialist throughout the process.

Financial Suitability Requirement:

This position requires a review of the applicant's financial history as part of the personnel security and suitability determination. Applicants must demonstrate financial responsibility, maintain good standing with creditors, and satisfy all legal financial obligations prior to applying.

Individuals with substantial delinquent or unresolved financial obligations-including, but not limited to, delinquent federal or state tax liabilities, defaulted federal student loans, court-ordered fines or fees, or child support arrears-may be deemed unsuitable for employment with the Indian Health Service (IHS).

Prior to the appointment, candidates must present two valid forms of identification. If one of the documents is a state-issued ID or driver's license, it must be REAL ID-compliant.

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-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: identifying and verifying patient eligibility for Medicare, Medicaid, SSA benefits, private insurance, Tribal programs, and other assistance resources; interviewing patients to obtain required documentation; assisting individuals and families with benefit applications; reviewing records to determine the status of claims and applications; responding to inquiries regarding patient eligibility requirements, benefits, and program guidelines; and maintaining accurate patient records through data entry, discrepancy resolution, and follow-up on pending claims and missing documentation.

GS-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: determining patient eligibility and preparing or issuing medical authorizations and denial determinations in accordance with established regulations and program requirements; identifying and verifying alternate resource coverage, including Medicare, Medicaid, VA benefits, and private insurance; researching and resolving discrepancies related to eligibility, claims, medical authorizations, coverage, and supporting documentation; coordinating referrals and follow-up with healthcare facilities to support continuity of care; and responding to inquiries from patients, providers, and agencies regarding eligibility, claims, and program requirements.

GS-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: applying and interpreting complex federal, state, Tribal, and private-sector regulations to make eligibility and funding determinations for programs such as Purchased/Referred Care, Medicare, Medicaid, Veterans Affairs healthcare, and Affordable Care Act plans; independently analyzing medical, financial, and eligibility documentation to resolve complex or controversial benefit issues; coordinating with agencies, providers, and patients to ensure fiscal accountability and continuity of care; issuing medical authorizations or denial determinations based on regulatory, clinical, and fiscal requirements; maintaining fund control records, monitoring expenditures, and applying appropriate accounting codes; identifying and resolving program or funding discrepancies; and compiling and analyzing reports related to program operations, funding, and utilization.

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 by the respective cutoff day of rating to be eligible for referral.

How you will be evaluated

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

This job announcement uses the USA Hire Assessment to evaluate applicants. There is no "pass/fail" outcome; results are used as part of the overall evaluation process to determine applicant qualifications. However, if you do not take the assessment within the assessment window timeframe you will be found ineligible for this position. For more information, visit the USA Hire Applicant Resource Center.

You will be evaluated based on how well you meet the qualifications listed in this vacancy announcement. 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 (knowledge, skills, abilities, and other characteristics):

• Accountability
• Attention to Detail
• Customer Service
• Decision Making
• Flexibility
• Influencing/Negotiating
• Integrity/Honesty
• Interpersonal Skills
• Learning
• Reading Comprehension
• Reasoning
• Self-Management
• Stress Tolerance
• Teamwork

Overstating your qualifications and/or experience in your application materials or application questionnaire may result in your removal from consideration. Cheating on an assessment may also result in your removal from consideration.

To preview the application questionnaire, click the following link: https://apply.usastaffing.gov/ViewQuestionnaire/12966833

Once the application process is complete, the first two pages of your resume and supporting documentation will be used to determine whether you meet the job qualifications.

Resume: You are highly encouraged to visit the USAJOBS Help Center before submitting a resume. USAJOBS Help Center - Update your resume now so it meets new resume requirements

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.

This is an Open Continuous Announcement. Applications will be reviewed and referred as vacancies occur; however, there may not be immediate openings at all locations.

During the application process, you may select up to five locations and will only be considered for positions in those locations. Candidates with complete applications will remain eligible for consideration for up to three months from the date of application or until the announcement closes, whichever occurs first. Consideration will be based on your selected locations, qualifications, and job preferences.

Positions may be filled at any of the grade levels listed in this announcement, with or without promotion potential. Applicants should indicate the lowest GS grade level they are willing to accept.

The first application cut-off date for referral consideration will be five business days after the announcement opens. After that, applications may be reviewed and referred at any time as vacancies occur.

Next steps

Additional locations