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Program Specialist - Customer Service Liaison

Company: Veterans Affairs, Veterans Health Administration
Location: Biloxi
Posted on: January 9, 2022

Job Description:

Summary The primary purpose of this position is to serve as Customer Service Liaison for the Office of Community Care (OCC) Program Section, an independent department within the Gulf Coast Veterans Healthcare System (GCVHS). This position serves as a patient advocate consistent with the mission, vision and values of the organization and those required by federal law. This position provides service recovery associated with the OCC. Responsibilities Duties include but are not limited to: Serves as the Customer Service Liaison for the Office of Community Care (OCC) Program Section, an independent department within the Gulf Coast Veterans Healthcare System (GCVHS). Provides service recovery associated with the OCC. Performs reviews by examining veteran's medical records, non-VA care authorizations, non-VA care payment records and historical tracking of submitted healthcare claims. Assist the Chief of OCC in conducting reviews in the areas of Non-Va Care Coordination and payment of claims related to non-VA care to attempt to resolve concerns from veterans and community providers. Leads the customer service efforts, demonstrating creativity and enthusiasm. Prepares recurring reports, data validation and timely response to special reporting requirements of he medical center as well as the payment center concerning this complex program. Ensures the OCC Program meets or exceeds program requirements. Serves as the liaison between the patient/family, vendor, Veterans Board of Appeals, Congressional Liaisons, District Counsel, Veteran's Affairs Medical Centers and the CFU, and provides a channel through which the VISN and GCVHS can respond to patient' needs and concerns. Receives and hears complaints, grievances and other requests for information from patients or from individuals acting on behalf of the patients. Responsible for providing timely updates on progress of work completed and claims that are moved back into processing and appropriate payment is confirmed Responsible for providing OCC Service Excellence Program weekly reports, monthly reports, quarterly reports, semi-annual reports and yearly reports to the GCVHS Pentad PCC Chief, VISN 16 Business Manager. Coordinates, provides assistance, and advise in the application of standards that affect the service. Develops, implements, and manages all aspects for the Service Excellence Program for the Office of community Care (OCC) Identifies problems or answers questions about entitlement and services that can or cannot be provided; identifies sources of difficulty in obtaining services; negotiates VA on behalf of the veterans; Makes appropriate referrals to other services within the VISN or community; provides follow-up to ensure that satisfactory service has been provided. Organizes, compiles, summarizes and analyzes the data collected and develops reports which reflect the scope of activities and identifies trends and opportunities for improvement. Ensures a systematic approach process for continuous collecting and evaluating customer service information and communication to and from management concerning the findings. Target actions and recommendations based upon comprehensive analysis of the results. Conducts performance reviews to determine the economy, efficiency, and effectiveness of program operations and to determine whether the entity has complied with laws and regulations applicable to the program. Responsible for planning, coordination, and evaluation of customer service initiatives and serves as an advisor on such issues. Responsible for developing administrative programs, procedures and policies that involve and direct the medical centers comprehensive customer service program to include our Veteran patients, their families/caregivers, staff throughout GCVHS. Develops annual plan, including objectives for process improvement in customer service and patient satisfaction related to the OCC processes. Investigates complaints, initiates action/appeals or change to rectify the situation and reports corrective measures taken to parties involved, when warranted. Monitors and evaluates corrective measures taken. Investigate all areas, files, records, personnel or other witnesses where any practice appears to violate patients' rights, entitlement to goods or services, or which causes unnecessary delay, discomfort or dissatisfaction to patients, their families, or the VISN and reports such finding with remedial recommendations. Make recommendations that meet non-VA care regulatory requirements and overall VA entitlement. Identifies and takes initiative regarding system inefficiencies and develops studies or data collection techniques related to specific identified problems. Work Schedule: Full-time, Monday-Friday, 8-hour shift between 7:30 AM and 5:00 PM, based on organizational needs. Telework: Not Available Virtual: This is not a virtual position. Position Description/PD#: Program Specialist - Customer Service Liaison/PD035270 Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required Requirements Conditions of Employment Qualifications To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 01/14/2022. Time-In-Grade Requirement: Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. For a GS-09 position you must have served 52 weeks at the GS-07. The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade. Note: Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment. You may qualify based on your experience and/or education as described below: Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-07 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Communicate effectively with others in order to gather information, present recommendations, foster teamwork and better coordination of services. Solve complex problems associated with the day to day operations concerning customer service issues in a positive, goal-oriented way, including the ability to take quick and effective action when necessary. Develop detailed training materials and teaching aids to conduct formal and informal training sessions to vendors and medical center staff. Leverage understanding of the polices, precedents, goals, objectives, laws, VA guidelines related to the authorization and payment for non-VA care in order to analyze and evaluate the continual changes in the program. Define an objective and propose solutions to critical management problems using health services research methods, including data collection and management methods, analysis design, interpretation of study results and translation of study results into action plans. OR, Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have master's or equivalent graduate degree, 2 full years of progressively higher-level graduate education leading to such a degree, or LL.B. or J.D., if related (transcripts required). OR, Combination: Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education beyond the first year. You will be rated on the following Competencies for this position: Analysis and Problem SolvingCustomer ServicePlanning and Evaluating 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; religions; spiritual; 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. Note: A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. Physical Requirements: The majority of work is performed in an office setting with adequate light, heat, and ventilation. Typical office setting is subject to noise caused by multiple visits by staff, equipment, and telephone interruptions when performing various functions on a daily basis. Work is mostly sedentary; however, standing during presentations or training, bending, and carrying light items is required. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/. Education A transcript must be submitted with your application if you are basing all or part of your qualifications on education. Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.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: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html. Additional Information Career Transition Assistance Plan (CTAP) provide eligible displaced Federal/VA competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation (a copy of the agency notice, your most recent performance rating, and your most recent SF-50 noting current position, grade level, and duty location) and be found well-qualified for this vacancy. To be well-qualified: applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the required competencies of the job. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website at http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/. This job opportunity announcement may be used to fill additional vacancies. If you are unable to apply online or need to fax a document you do not have in electronic form, view the following link for information regarding an Alternate Application.

Keywords: Veterans Affairs, Veterans Health Administration, Biloxi , Program Specialist - Customer Service Liaison, Other , Biloxi, Mississippi

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