The position is located within a CPAC, organizationally aligned under the Chief Operating Officer, with the Incumbent serving as the Insurance Verification Manager for the first and third party Revenue Program (MCCF) and Pharmacy Team.

Qualifications:

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 09/21/2026.

Time-In-Grade Requirement :

Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. For a GS-11 position you must have served 52 weeks at the GS-9. The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials.

If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade.

Note:

Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment. You may qualify based on your experience and/or education as described below:

Specialized Experience:

You must have one year of specialized experience equivalent to at least the next lower grade GS-9 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Managing or coordinating insurance verification and/or pharmacy claims processing activities, including pre-registration, eligibility verification, or accounts receivable follow-up in a healthcare or medical billing setting. Applying federal healthcare regulations, statutes, or agency policy (e.g., VHA revenue cycle directives, Tricare/CHAMPVA billing requirements) to analyze and resolve program or compliance issues. Analyzing financial or program data (e.g., billing, collections, or accounts receivable reports) to identify trends, measure performance, and develop recommendations for improving revenue cycle or program operations. Developing or implementing management studies, procedures, or internal controls to improve organizational effectiveness in a financial administration or revenue operations program. Supervising, leading, or providing technical direction to staff performing financial, administrative, or claims-processing work, including assigning work, evaluating performance, and identifying training needs. Preparing and presenting complex reports or data to management or leadership (e.g., performance metrics, diagnostic measures, quality assurance findings) to support decision-making. Communicating with internal and external stakeholders (e.g., insurance carriers, medical center leadership, VISN or network officials) to resolve disputes, negotiate compliance, or coordinate program activities.

OR, Education:

Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have 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.

OR, Combination:

Applicants may also combine education and experience to qualify at this level. You must have an combination of specialized experience and education to qualify at the GS-11. This can be determined by adding total qualifying experience as a percentage of the required experience and education as a percentage of the total required. The total percentage must equal 100 percent. Only education more than the first 18 semester hours (i.e. beyond the first-year graduate level education) is creditable towards meeting the specialized experience requirement. A transcript must be submitted with your application if you are basing all or part of your qualifications on education. 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; religions; 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.

Note :

A full year of work is considered to be 35-40 hours of work per week. 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.

Physical Requirements:

The work is primarily sedentary, although some slight physical effort may be required. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at http://://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/ .