Summary
This position is located within the Department of Homeland Security (DHS), Immigration and Customs Enforcement (ICE), Enforcement and Removal Operations (ERO), ICE Health Service Corps (IHSC), Office of Deputy Assistant Director for Healthcare Compliance, Health Plan Management Unit (HPMU). This is a supervisory position.
This position is only open to USPHS officers who are currently IHSC employees.
USPHS Call to Active Duty (CAD) candidates are not eligible for this position.
This job is open to
Clarification from the agency
Applicants must be a current USPHS Commissioned Corps Officer who works at IHSC.
USPHS Call to Active Duty (CAD) candidates are not eligible for this position.
Civilians are not eligible for this position.
Duties
DUTIES AND RESPONSIBILITIES:
- Serves in the capacity of Regional Utilization Manager and subject matter expert in the oversight of program activities and policies related to utilization review and management. Duties include day to day managing, assessing, planning, developing, budgeting, implementing, and evaluating assigned programs. Incumbent reviews, revises, and, or writes policies, provides technical oversight on contracts, formulates, and executes short- and long range plans for optimum utilization of personnel, facilities and equipment. Incumbent ensures compliance with program regulations (e.g., appropriateness of health care and services based on regulatory, reimbursement requirements, evidence-based national care guidelines and evidence-based practices), maintains records per program policy, chairs meetings, coordinates and, or, manages programs within immediate organizational component. Communicates and collaborates with individuals or groups from outside the agency, including consultants and contractors. Work purpose is primarily to collaborate; supply advice; explain, interpret and seek support for methods, policies and programs; or render a service of a moderately complex nature requiring a moderate amount of explanation and tact (e.g., support for budget).
- Supervises utilization review consultants (URC), in the conduct of all aspects of management of assigned functions related to administrative management. Reviews and approves URC leave, training, and travel requests. Provides oversight and consultation to URCs regarding Medical Payment Authorization Requests (MedPARs) for select reimbursable health care services and medical claims review. Ensures subordinate staff provide adequate coverage (e.g., TDY and leave absences).
- Liaises regionally and, or, nationally with applicable stakeholders internal and external stakeholders (e.g., Customs and Border Patrol, Veterans Affairs) regarding utilization management (UM) processes, trainings, and principles to ensure inpatient stays are within DRG limitations and, or, extended length of stays as appropriate per national evidenced based guidelines.
- Provides orientation and guidance to the respective ICE, custody, and medical staff members of facilities in which ICE detainees are held regarding ICE policies, reporting requirements, and applicable ICE detention standards.
- Judgmental failure can result in ineffective or inappropriate use of resources and delays in meeting public health objectives of the office or agency. This may also impair the development of systems, affect the work of subordinate employees, and compromise the delivery of other administrative and personnel services.
- Travel may be required - estimated 15%. Travels TDY as needed to provide clinical care support at IHSC-staffed detention facilities with critical staffing needs.
- Incumbent responsibilities as a contracting officer representative (COR) or technical monitor are commensurate with the complexity, value, technical direction, and monitoring required for a given contract and are specified in the Appointment Letter. The incumbent performs duties and comply with the responsibilities and limitations specified in the Appointment Letter including the documentation of actions taken under such delegation of authority.
- Performs other duties and responsibilities as assigned
Requirements
Conditions of Employment
- You must be a U.S. citizen to apply for this position.
- You must successfully pass a background investigation.
- You must successfully pass a drug screen.
- Males born after 12/31/59 must certify registration with Selective Service.
- Requirements by Closing Date: Unless otherwise noted, you must meet all requirements by the closing date of the announcement.
- Probationary Period: This is a full-time permanent position (Career/Career-Conditional appointment). Upon appointment to this position, you may be required to serve a one-year probationary period.
- Applicants must be a current USPHS Commissioned Corps Officer who works at IHSC.
USPHS Call to Active Duty (CAD) candidates are not eligible for this position.
Civilians are not eligible for this position.
Qualifications
PHYSICAL DEMANDS:
- Required to walk unaided at a normal pace for up to 5 minutes and maintain balance.
- Required to jog/fast walk up to ¼ mile.
- Required to perform CPR/emergency care standing or kneeling.
- Must have the ability to assist sick, injured, or aging detainees or staff exiting the building (may require lifting, dragging, wheeling, or carrying someone who weighs significantly more than oneself).
- Sitting and/or standing for extended periods of time [6-8 Hours].
- Performing repeated bending motion.
- Average manual dexterity for computer operation.
- Phone use for extended periods of time.
Education
REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES:
- Incumbent must possess a minimum of five years of professional experience relevant to the officer's category. Of the total professional experience, officer must possess at least two years of experience related to management, administration, or evaluation of public health programs. Healthcare management or utilization management is preferred.
- Meet the minimum education requirements for either a nurse, nurse practitioner, or physician assistant.
- Nurse. Must possess a qualifying bachelor's degree in nursing or a master's degree in nursing (with no qualifying bachelor's degree) accredited by the National League for Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE). Master's degree is preferred.
- Nurse practitioner. Must possess a certified advance practice nurse practitioner degree from a graduate school training program approved for this qualifying degree.
- Physician assistant. Must possess an accredited bachelor's, or master's degree, and completed a physician assistant training program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), and national certification through the National Commission on Certification of Physician Assistants (NCCPA). Master's degree is preferred.
- Incumbent must possess at minimum a Level II COR 40 hour course certificate or must obtain one 12 months from hire through the Defense Acquisition University (DAU) and Federal Acquisition (FAI) Cornerstone OnDemand (CSOD) online comprehensive learning platform.
- Incumbent must possess at a minimum an industry certification related to billing, coding, and utilization/case management [e.g., MCG Care Guideline Specialist, Certified Professional Medical Auditor (CPMA), or Certificed Inpatient Coder (CIC)] or must obtain within 12 months of hire.
- If the incumbent holds a clinical license, it is the responsibility of the incumbent to fulfill the obligation(s) of their licensing or certifying body to maintain current status. The agency may require the incumbent performs clinical activities with the scope of clinical license in times of critical needs within the agency. If in a clinical discipline and as directed and approved by his/her supervisors, the incumbent may perform clinical duties of their profession in Federal health care facilities. Such direction is documented via a memorandum of assignment and is filed in the eOPF.
- Well-developed knowledge and skills in the areas of utilization management and medical necessity.
- Currently has or can achieve and maintain utilization management or other applicable certification as directed by IHSC through formal training and other means.
- Supervisory experience preferred
- Knowledge of medical, administrative, ethical, and legal requirements and standards related to healthcare delivery.
- Currently has or can achieve and maintain utilization management or other applicable certification as directed by IHSC through formal training and other means.
- Should possess some knowledge of International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10), current procedural terminology (CPT), diagnosis-related group (DRG), and other Centers for Medicare and Medicaid Services (CMS) coding/billing requirements.
- Ability to critically analyze situations, data and information, and be able to develop and pose probing questions, identify problems, and make recommendations towards their resolution.
- Maintains clinical professional skills via continuing education opportunities.
- Maintains CPR/BLS certification.
- Professional background in health care with extensive direct patient care experience, preferably within a correctional setting.
- Computer literate on Adobe and MS Office applications.
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.
We will review your resume and supporting documentation to ensure you meet the minimum qualification requirements. You may be selected for an interview at the hiring authority's discretion. You will be notified of selection or non-selection.
Required Documents
To apply for this position, you must provide a complete Application Package. Please note that if you do not provide all required information, as specified in this announcement, you may not be considered for this position.A complete application includes:
U. S. Public Health Service Officers
- Cover Letter/Letter of Interest. Please include location preference here.
- Degrees. (Place under "Diploma/GED")
- Professional license. (If applicable)
- Additional professional certificates. (If applicable)
- Three professional references. (i.e., name, title and contact information)
- Official USPHS Promotion CV - e.g., relevant experience, education, training. (Place under "Resume")
- *Three most recent Commissioned Officer Effectiveness Reports (COER). (Place under "Performance Appraisal")
- A copy of your current Service Remaining Requirements Agreement.
- Indicate if you have an Assignment Pay (AP) Agreement and the date of the end of your AP Agreement.
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 submit the required documentation outlined under the REQUIRED DOCUMENTS section below.
The complete initial Application must be submitted by 11:59 PM (EST) on 06/28/2024.
PLEASE NOTE: If your materials are not received by the closing date, your application will be evaluated solely on the information available and you may not receive full consideration or may not be considered eligible. Also, if you do not provide a valid email address, you may not be notified of the outcome of your application.
To begin the process, click the Apply Online button to create an account or log into your existing USAJOBS account. Follow the prompts to complete the occupational questionnaire. Please ensure you click the Submit My Answers button at the end of the process.
Note: To check the status of your application or return to a previous or incomplete application, log into your USAJOBS account, select Application Status, and click on the more information link under the application status for this position.
Applications and supporting documentation will not be accepted by mail or email. If you need further assistance, contact the Human Resources Office representative listed on this announcement at least one day prior to the closing date for further instructions.
Next steps
Once you submit your application, we will assess your experience and training, identify the best-qualified applicants, and refer those applications to the hiring manager for further consideration and interviews. We will notify you by email after each of these steps has been completed. Your status will also be updated on USAJOBS throughout the process. To check your status, log on to your USAJOBS account, click on "Application Status," and then click "More Information." We expect to make a job offer within 60 days after the deadline for applications. If you are selected, we will conduct a suitability/security background investigation. View more information on applying for federal employment.
|