|SUPERVISORY HEALTH SYSTEM SPECIALIST-AREA
This position is organizationally located in the Contract Health Services Division, Area Office, Indian Health Service. The function of the Contract Health Services Division is to plan, implement, coordinate and monitor all contract health services within the Area. The purpose of this position is to manage the Contract Health Services Division, Area contract health program and to serve as Area technical consultant for Area and field managers on all Contract Health Services matters.
II. Major Duties:
Serves as principal advisor on the Contract Health Services Program on policy development, interpretation and implementation to Area and Service Unit staff and professional staff in the private health care sector. Incumbent is responsible for ensuring that IHS and Area regulations, policies and procedures relating to Contract Health Services are executed. Develops new program guidelines and policies as required and represents IHS in meetings with other federal, state and local officials, tribal organizations, educational institutions and other private health care providers to develop health care resources and to convey an understanding of the Contract Health Services Program.
Incumbent works with Headquarters, Area Office and Service Unit professional staff on comprehensive program planning to insure that CHS Program is effectively integrated into a comprehensive health care delivery system. Incumbent works with Tribal groups in the redesignation of CHS Delivery Areas which affects CHS funds, the number of people served and patient eligibility.
Incumbent independently defines, and develops contract requirements and serves as lead negotiator in negotiation of contracts with private vendors. Determines reasonableness of rates obtained for all health services through periodic review of prevailing rates obtained from such sources as insurance intermediaries, V.A. fee schedules and Title 19 Program.
Incumbent responds to all CHS inquiries and requests for health care assistance including highly complex, extensive and sensitive Congressional inquiries. Such requests invariably originate from distant locations and require coordination with other IHS Areas, other Federal and state agencies, private hospitals, and other health care providers.
Assures equitable distribution and management of CHS funds allocated to the Area or collected through Third party alternate resources. Through funds expenditure analysis and knowledge of changing health care requirements, monitors CHS Program spending plans, funds status throughout the Area and recommends adjustments as needed
Assigns, schedules, and directs the work assignments to Contract Health Specialist(s) and clerical support. Determines the nature and complexity of the work to be performed and the relative priorities involved, the capabilities of the employees relative to the existing workload and availability of staff. Provides both technical as well as administrative supervision including leave approval, performance appraisal, counseling, disciplining and selection of employees. Actively supports and complies with current EEO policies and guidelines.
Performs other related duties as assigned.
1. Knowledge required by the position: Knowledge of Contract Health Services Delivery policies, procedures and guidelines.
Knowledge of direct health care delivery systems.
Knowledge of rate determination sources and methods.
Knowledge of third party alternate resource methodologies.
Knowledge of federal laws pertaining to health care delivery.
Knowledge of health care financing. Knowledge of sound management and supervisory skills. Knowledge of managed care principles. Knowledge of acquisition/contracting methodologies. Knowledge of negotiation methods. Knowledge of EEO Policies and Regulations.
2. Supervisory Controls: The incumbent is under the general supervision of the Associate Area Director, who provides direction by broadly defining, goals and objectives to be achieved. The incumbent proceeds independently to execute assignments receiving only administrative supervision.
Recommendations made by the incumbent are accepted almost without exception. Work is reviewed primarily in terms of results achieved.
Guidelines include Federal, State, and local laws as well as IHS Circulars and procedural manuals. The incumbent uses independent judgment in interpreting and adapting broad guidelines to specific situations. The incumbent develops local CHS policies and procedures and uses independent judgment in their application.
Work consists of analysis, and evaluation of interrelated issues of substantive CHS program I issues. Work requires developing detailed plans for long range implementation of programs and developing criteria for evaluating their effectiveness. Work is difficult to analyze due to changing health care needs as well as rapid changes in legislative and regulatory requirements. The subjective nature of the work includes value judgments and predictive measurement requirements used in multi disciplinary matters ranging from health care financing to clinical situations.
5. Scope and Effect:
This position is the focal point for advice and guidance for the CHS Program. The purpose of the work is to provide the full range of assessment needs and planning for care. Failure to properly plan, evaluate and monitor activities of the Contract Care Program would result in a material weakness of a most grievous nature both in funding as well as in clinical health care delivery.
6. Personal Contacts:
Incumbent comes into contact with not only employees within the CHS Division but also with a wide diversity of outside groups and individuals including other Federal, State and Local agencies, private sector health care delivery systems, insurance carriers and intermediaries, private vendors, congressional staff and a host of others.
7. Purpose of Contacts:
The purpose of contacts include negotiations for fee, fee assessment, program evaluation, and information dissemination. In a majority of instances contacts are fraught with disagreement, controversy and adversity both from the provider as well as the patient. This requires considerable tact and demeanor on the part of the incumbent.
8. Physical Demands:
The work of the position requires little in the way of physical exertion.
Work is performed primarily in an office and clinical setting with minimum exposure to disease.
Position: SUPERVISORY HEALTH SYSTEMS SPECIALIST, GS-671-13
Organizational Location: Contract Health Services Division, IHS Area Office.
Standards Referenced: OPM PCS for Health Systems Specialist, GS-671, 12/79; Grade Level Guide for the Evaluation of Program Specialists; Health System Administration, GS-670-12/79; IHS Classification Guide for Contract Health Positions 9/88.
Title and Series Determination:
Subject position serves as the CHS division director and provides CHS technical consultation to managers and staff in an Area Office of IHS. Work involves planning, analysis, monitoring and evaluation of a Health Care Delivery System which meet the series definition coverage criteria depicted in the cited GS-671 position classification standard. Since the position contains supervisory assignments, the position is appropriately titled Supervisory Health Systems Specialist in accordance with titling instructions in cited standard.
Title and Series Allocated: Supervisory Health Systems Specialist, GS-671-13.
Grade Level Determination:
The Guide for the Evaluation of Program Specialist positions describes grading criteria for grade levels GS-9 through GS-13.
This Indian Health Service position is compared to the GS-12/13 criteria as follows:
Typical example of a GS-12 level assignment would be the total operation of an established program administered by state and local community agencies to identify the nature and source, both of problems and of successful operation practices in all areas of operation e.g., competency of staff, organizational structure, resources, with other agencies and organizations.
As to level of responsibility, the Supervisor provides guidance to the GS-11 or GS-12 program specialist(s). Or a higher level program specialist during the time they are working on a complete project or program.
Positions at the GS-13 Grade Level are responsible for developing program material at the Area, Regional or National level. This position acts as a consultant to the Area Director and Management Staff in the Contract Health Service function and is considered to be characteristic of the GS-13 level of responsibility depicted in the cited Guide. Comparison of subject position with the GS-685, GS-343 and the DHHS Position Classification Guide for CHS positions all of which support the GS-13 allocation.
Conclusion: Supervisory Health System Specialist GS-13.
Vernon E. Hohmann
Position Classification Specialist, IHS
April 5, 1994