Health System Specialist (Medical Designator/Utilization Review Administrator)

Corrections professionals who foster a humane and secure environment and ensure public safety by preparing individuals for successful reentry into our communities.

Major duties

Serves under the general supervision of the Regional Health System Administrator (RHSA), in the primary area of assisting in the coordination of program planning and review, budgeting, decision analysis, systems evaluation, medical staff training, and health care policy. Provides resources for the overall planning and policy development of health services delivery at all health facilities within the Region. Recommends corrective action to resolve problem areas and changes in program direction affecting health services delivery resources and efforts to the RHSA. Responsible for the comprehensive planning, policy development, preparation and coordination of various regional cost center budget activities.

Qualifications

To be considered for the position, you must meet the following qualification requirements. Basic Requirements: Education: Undergraduate and Graduate Education: Major study - hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration. OR Specialized Experience: Progressively responsible analytical or administrative, or clinical management or supervisory experience in the health care field. This work may have been performed in an operating health care facility or a higher organizational echelon with advisory or directional authority over such facilities. Work must have involved a close working relationship with facility managers and analysis and/or coordination of administrative, clinical, or other service activities, and provided knowledge of the following: Missions, organizations, programs, and requirements of health care delivery systems; Regulations and standards of various regulatory and credentialing groups; and Government-wide, agency, and facility systems and requirements in various administrative areas such as budget, personnel, and procurement. OR Special Provision for Inservice Placement: Successful completion of an agency-sponsored on-the-job training program may be substituted for qualifying experience, provided it included a formal individualized training plan. Such a training program must have been conducted in an operating health care system and included: Assignments providing a knowledge of basic health system administration philosophies, practices, and procedures, and basic government administrative policies and requirements; Practical assignments providing an opportunity to apply health system administration skills and principles (as the individual progresses, work assignments must be characteristic of the grade level to which he or she is assigned); and Oversight by an experienced health system administrator with periodic evaluation of the individual's progress and appropriate adjustment of the training program. AND In addition to meeting the Basic Requirements, applicants must have the following: Education: GS-11: Ph.D. or equivalent doctoral degree or 3 full years of progressively higher-level graduate education leading to such a degree or LL.M, if related. Major study must be in - hospital administration, public health administration, or related fields, such as business or public administration with course work in health care administration. GS-12: There is no substitution of education for specialized experience for this position. OR Experience: GS-11 and GS-12: You must have at least one year of specialized experience equivalent in difficulty and complexity to the next lower grade level. To be creditable, this experience must have equipped the applicant with the particular qualifications to successfully perform the duties of the position and must typically be in or related to the position to be filled. Some examples of this qualifying experience are: GS-11: Understanding the distinct healthcare requirements within a correctional environment and effectively establishing a well-round system for delivery of medical services. Knowledge of administrative management and leadership skills to ensure administrative support of all activities in a correctional health care delivery system. Knowledge of policies, procedures and standards of the institutions, Health Services, BOP, and accrediting bodies. Experience in applying basic fiscal management principals within a medical setting, understanding of agency's budget systems, and awareness of the cost of medical services and equipment. GS-12: Knowledge of comprehensive planning and policy development for the delivery of health services that encompass key areas such as workflow engineering, supply chain management, and medical administration. Experience in employee management, fostering a positive workplace culture that promotes collaboration, conflict resolution, and workforce engagement to maintain operational efficiency during staff shortages or critical situations. Experience in interpreting data analytics activities and trends, translating findings into actionable strategies, and optimizing healthcare operations through data-driven approaches. Experience in budget management focused on cost containment, contracting services, and inventory control, ensuring efficient resource allocation and financial sustainability. OR Combination of Education & Experience: GS-11 Only: A combination of education and experience. This experience must have equipped you with the qualifications to perform the major duties of this position as described above. If applicable, credit will be given for paid and unpaid experience. To receive proper credit, you must show the actual time (such as the number of hours worked per week) spent in activities. Your eligibility for consideration will be based on your responses to the questions in the application.

Education

ONLY if education is a requirement/substitution for specialized experience, applicant MUST upload legible transcripts as verification of educational requirement. Transcripts MUST be uploaded and electronically linked from USAJOBS at the time you apply and MUST include identifying information to include School Name, Student Name, Degree and Date Awarded (if applicable). All academic degrees and coursework must be completed at a college or university that has obtained accreditation or pre-accreditation status from an accrediting body recognized by the U.S. Department of Education. For a list of schools that meet this criteria, Click Here. Foreign Education: For information regarding foreign education requirements, please see Foreign Diploma and Credit Recognition at the U.S. Department of Education website: Recognition of Foreign Qualifications.

Requirements

Career Transition Programs (CTAP or ICTAP): These programs apply to Federal and/or DOJ employees who meet the definition of surplus or displaced from a position in the competitive service. To receive selection priority for this position, you must: Meet CTAP or ICTAP eligibility criteria; Be rated well-qualified for the position, scoring at least half of the total possible points for the vacancy KSAs or competencies; and Submit the appropriate documentation to support your CTAP eligibility: A copy of the agency notice (i.e., separation notice or agency RIF letter), Most recent performance appraisal, and Most recent SF-50 showing current/former position, grade, promotion potential, and duty location. See USAJOBS' Career Transition Programs for more information. EEO Statement/Policy: The United States government does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service or other non-merit factor. More information can be found here: U.S Department of Justice - Equal Employment Opportunity Policy Key Requirements: U.S. Citizenship is Required. See Special Conditions of Employment Section. Selective Service Requirement