This position will serve as a Consult Authorization Clerk for the Non-VA Care Coordination (NVCC) Program and the Veteran's Choice Program in the Business Service for the San Francisco VA Health Care System (SFVAHCS), San Francisco, CA.
The NVCC Program office is responsible for processing all Non-VA Care authorizations and provides coordination of the Veteran's Choice Program and all aspects of Non-VA healthcare between the SFVAHCS, Community Based Outpatient Clinics and community facilities, vendors and providers.
Reviews eligibility determinations for the various programs in Non-VA Care.
Works closely with the utilization review clinical staff to insure proper authorizations are issued and appropriate correspondence is sent to vendors.
Confirms Veteran's eligibility for specialty programs in the NVCC programs and appropriately processes their authorizations.
Discusses eligibility for programs or specific consults with vendors, Veterans, and/or service officers.
Performs data entry of Veteran's Non-VA appointments, telephone communications, private insurance capture, and entering NonVA Care authorizations.
Consolidates Non-VA clinical documents and reports in accordance with established procedures, i.e. for completeness and enters pertinent information into an automated tracking system, uploads into Vista Imaging, and completes consults.
Consults with VA clinicians, third party administrators and non-VA providers to effectively support continuity of care.
Performs other duties as assigned.
Work Schedule: Monday thru Friday, 8:00 a.m. to 4:30 p.m.
Recruitment & Relocation Incentives: Not authorized
Financial Disclosure Report: Not Required
Job family (Series)
0303 Miscellaneous Clerk And Assistant
Conditions of Employment
You must be a U.S. Citizen to apply for this job
Subject to a background/security investigation
Designated and/or random drug testing may be required
Selective Service Registration is required for males born after 12/31/1959
May be required to serve a probationary period
Selected applicants will be required to complete an online onboarding process
SPECIALIZED EXPERIENCE: MUST possess at one (1) year of specialized experience that equipped you with the particular knowledge, skills and abilities to perform successfully the duties of this position, and that is typically in or related to the work of this position. To be creditable, this experience must have been equivalent to at least the GS-5 grade level in the Federal Service. Specialized experience includes: Possessing knowledge of the regulations and applicable state laws related to patient eligibility and also Non-VA Care; possessing skill in establishing priorities, and working independently, managing multiple concurrent priorities; using a computer and associated software which includes Microsoft Excel, Power Point, Word, Outlook and a printer to perform office duties and required advising and processing NON-VA Coordinated Care claims; coordinating and submitting expense reports; planning and scheduling meetings; maintaining and tracking files and documents; and analyzing, organizing, and presenting orally and in writing complete and accurate materials. (This experience must be documented in your resume.)
You will be rated on the following Competencies as part of the assessment questionnaire for this position:
IMPORTANT: A full year of work is considered to be 35-40 hours of work per week. All experience listed on your resume must include the month and year start/end dates. 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.
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; 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.
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/ .
There is no educational substitution at this grade level.
Physical Requirements: The work is sedentary. Typically, the employee sits comfortably to do the work. However, there may be some walking; standing; bending; carrying of light items such as papers, or books, etc. No special physical demands are required to perform the work.
Receiving Service Credit for Earning Annual (Vacation) Leave: 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. VA may offer newly-appointed Federal employee's credit for their job-related 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. Such credit must be requested and approved prior to the appointment date and is not guaranteed.
Special Employment Consideration: VA encourages persons with disabilities to apply, including those eligible for hiring under 5 CFR 213.3102(u), Schedule A, Appointment of persons with disabilities (i.e., intellectual disabilities, severe physical disabilities, or psychiatric disabilities), and/or disabled veterans with a compensable service-connected disability of 30% or more. For more information on how to apply using this appointment authority via the Selective Placement Coordinator within the office, contact the facility Human Resources Department at (415) 221-4810.
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.
The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced Federal competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation and be found well-qualified (have a final rating of 85 or more before any Veterans preference points) for this vacancy. 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 view the following link for information regarding an Alternate Application .
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 WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. If your resume does not support your questionnaire answers, we will not allow credit for your response(s).
Your responses to the assessment questionnaire will be reviewed along with the information provided in your resume and supporting documentation to determine if you are qualified for the position. If, after reviewing your resume and/or supporting documentation, a determination is made that you have inflated your qualifications and or experience, your rating may be lowered and/or you may lose consideration for this position. Please follow all instructions carefully. Errors or omissions may affect your eligibility.
Candidates who apply under All U.S. Citizens announcements will be rated and ranked using Category Rating procedures. Qualified candidates will be assigned to a quality category. The categories are defined as follows:
Best qualified - applicants possessing experience that substantially exceeds the minimum qualifications of the position including all selective factors, and who are highly proficient in all requirements of the job and can perform effectively in the position;
Highly qualified - applicants possessing experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the requirements of the job;
Well qualified - applicants possessing experience that meets the minimum qualifications of the position including all selective factors, and who are proficient in some, but not all, of the requirements of the job; and
Qualified - applicants possessing experience and/or education that meets the minimum qualifications of the position including all selective factors.
Application of Veterans' Preference : Category rating and selection procedures place those with veteran's preference above non-preference eligibles within each category. Preference eligible applicants that meet the eligibility and qualification requirements and who have a compensable service-connected disability of at least 10 percent are listed in the highest quality category (except when the position being filled is scientific or professional at the GS-09 grade level or higher).
Background checks and security clearance
Drug test required
IMPORTANT: Please ensure your resume include up-to-date contact information (phone number(s), email address(s), etc.)
To apply for this position, you must provide a complete Application Package which includes:
The following documents are accepted, and may be required if applicable to your eligibility and/or qualifications for this position. Please use this checklist to ensure you have included all documents required for your application, such as a copy of your transcript (if using education to qualify), SF-50's (current/former Federal employees), documentation to support Veterans Preference or ICTAP/CTAP documentation (for displaced Federal employees).
VA Disability Letter
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 http://www.fedshirevets.gov/job/vetpref/index.aspx .
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.
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. Learn 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.