Program Specialist

Job Title

Program Specialist

Duties

The incumbent conducts reviews as required by their direct supervisor and medical center leadership. Other duties include, but are not limited to, the following:

• Contact members of the hospital staff at all levels concerning patient care issues not been resolved by other services and seeks resolution utilizing the full resources of the medical center and VA system.
• Explore all avenues, crossing lines of authority and responsibility within the medical center, to identify the nature and scope of the problem and to initiate appropriate action for resolution.
• Independently resolves the most difficult, complex, and sensitive care issues and system-related problems, applying advanced judgement across multiple program areas and organizational levels.
• Gather, analyze, and prepares information using sound judgement in response to inquiries, including Congressional Offices, White House Hotlines, Advance Credit Reports (ACR), VAIQs, Exec VA, CBI Helpline, Call Center Portals, and Reports of Contact while managing relationships across business units.
• Reviews files and records, and discusses with personnel or witnesses regarding any practice that appears to violate patient's rights or which causes unnecessary discomfort or embarrassment to patients, their families, or the health care facility and reports such findings with recommendations for improvements to the facility Director and/or top management team.
• Ensure national VA patient advocacy program requirements are met by collecting, analyzing, and evaluating relevant data, and preparing meaningful reports based on that data. - Evaluates the effectiveness, efficiency, and compliance of Community Care operations and related processes, and develops data-driven recommendations for improvement.
• Applies analytical and evaluative methods to assess program performance, identify trends, and recommend enhancements to improve service delivery and patient outcomes.
• Serve as an advocate for patients throughout Community Care Service, receiving and addressing complaints and grievances from patients or their representatives.
• Provides explanation regarding Veteran eligibility/entitlement to benefits according to the Veterans' Benefit Package and the laws and regulations governing VA authority to authorize payment for care in the community.
• Communicate with the Veteran to assist in filing claims and explain what action is needed by the Veteran to support their claims.
• Receives telephone calls regarding denied or rejected claims and coordinates with appropriate personnel when additional information is required for further review.
• Provides consultative guidance to leadership, staff, and stakeholders regarding patient advocacy issues, program operations, and regulatory requirements.
• Interprets and applies Federal laws, VA regulations, policies, and procedures to ensure compliance with the Mission Act and other governing authorities.
• Coordinates and reroutes calls appropriately with multiples departments are involved.
• Facilitates and follows through to ensure final resolution to the customer.
• Performs all other duties as assigned.

Promotion Potential

The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level.

Work Schedule

Monday through Friday, 8:00am to 4:30pm (Tour may be subject to change based on needs of the facility).

Position Description/PD#: Program Specialist/ PD132990

Relocation/Recruitment Incentives: Not Authorized

Critical Skills Incentive (CSI): Not Authorized

Permanent Change of Station (PCS): Not Authorized

Financial Disclosure Report: Not required

30 Day Hiring Model

The Department of Veterans Affairs is implementing a streamlined 30-Day Hiring Model designed to accelerate hiring while maintaining the highest standards of merit-based selection. This improved process reduces traditional hiring timelines by integrating early coordination, faster assessments, and efficient pre-employment actions. Applicants can expect a more transparent, predictable, and efficient hiring journey from announcement to entry on duty.

What Applicants Can Expect

• Expedited Candidate Review Once the announcement closes, Human Resources will quickly review applications, issue certificates of eligible candidates the day after the announcement closes and refer applicants for hiring manager consideration.