Supervisory Health System Specialist (PRC)

Summary

Health System Specialist

This position is organizationally located in the Purchased and Referred Care (PRC) program at the Phoenix Indian Medical Center (PIMC) located in Phoenix, AZ. The purpose of this position is to provide support and technical assistance to the Service Unit management on matters involving processing PRC Referrals. Serves as the Supervisor of the Referrals section within the PRC program. A REAL ID will be required beginning May 7, 2025, in accordance with 6 C.F.R. 37.5 (2021).

Responsibilities:

• Manages and oversees Purchased/Referred Care and related programs, ensuring compliance with IHS policies, coordinating with leadership, and advising on program operations, regulatory requirements, and strategic planning.
• Leads program improvement and stakeholder engagement, implementing quality controls, managing appeals and claims, educating patients and partners, and maximizing use of alternative resources to enhance program effectiveness and compliance.
• Oversees high-risk case management, ensuring eligibility compliance, timely reporting, effective referral coordination, and providing guidance, education, and oversight to support managed care processes.
• Directs and supervises program staff and operations, overseeing work planning, assignments, performance management, hiring, training, and employee relations while improving productivity, maintaining quality standards, and ensuring effective program execution.

Requirements:

Conditions of Employment:

• Selectee may be subject to a probationary period.
• ESEP appointees typically serve a two year trial period.
• U.S. Citizenship is required.
• Selective Service Registration is required for males born after 12/31/1959.
• This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children.
• A one-year supervisory/managerial probationary period may be required upon selection/placement.
• On-call hours or standby duty may be required.
• Successfully pass the E-Verify employment verification check.
• You will need to set up direct deposit so we can pay you.
• Background Investigation Requirement: This position requires the successful completion of a federal background investigation as a condition of employment.
• Financial Suitability Requirement: This position requires a review of the applicant's financial history as part of the personnel security and suitability determination.

Qualifications:

To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying. 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; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week.

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.
• Special Provision for In-service Placement: Successful complete of an agency-sponsored on-the-job training program may be substituted for qualifying experience, provided it included a formal individualized training plan.

Minimum Qualifications:

• GS-12: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level (GS-11) in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks:

Job Description

Health System Specialist

This position is organizationally located in the Purchased and Referred Care (PRC) program at the Phoenix Indian Medical Center (PIMC) located in Phoenix, AZ. The purpose of this position is to provide support and technical assistance to the Service Unit management on matters involving processing PRC Referrals. Serves as the Supervisor of the Referrals section within the PRC program. A REAL ID will be required beginning May 7, 2025, in accordance with 6 C.F.R. 37.5 (2021).

Responsibilities:

• Manages and oversees Purchased/Referred Care and related programs, ensuring compliance with IHS policies, coordinating with leadership, and advising on program operations, regulatory requirements, and strategic planning.
• Leads program improvement and stakeholder engagement, implementing quality controls, managing appeals and claims, educating patients and partners, and maximizing use of alternative resources to enhance program effectiveness and compliance.
• Oversees high-risk case management, ensuring eligibility compliance, timely reporting, effective referral coordination, and providing guidance, education, and oversight to support managed care processes.
• Directs and supervises program staff and operations, overseeing work planning, assignments, performance management, hiring, training, and employee relations while improving productivity, maintaining quality standards, and ensuring effective program execution.

Requirements:

Conditions of Employment:

• Selectee may be subject to a probationary period.
• ESEP appointees typically serve a two year trial period.
• U.S. Citizenship is required.
• Selective Service Registration is required for males born after 12/31/1959.
• This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children.
• A one-year supervisory/managerial probationary period may be required upon selection/placement.
• On-call hours or standby duty may be required.
• Successfully pass the E-Verify employment verification check.
• You will need to set up direct deposit so we can pay you.
• Background Investigation Requirement: This position requires the successful completion of a federal background investigation as a condition of employment.
• Financial Suitability Requirement: This position requires a review of the applicant's financial history as part of the personnel security and suitability determination.

Qualifications:

To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying. 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; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week.

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.
• Special Provision for In-service Placement: Successful complete of an agency-sponsored on-the-job training program may be substituted for qualifying experience, provided it included a formal individualized training plan.

Minimum Qualifications:

• GS-12: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level (GS-11) in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: