Overview

<b>Duties</b><br /><br /><b>Summary</b><br /><br />You will serve as a SUPERVISORY NURSE CONSULTANT in the Referral Management Department for the Directorate of Healthcare Business as a part of NHLTHCLINIC PATUXENT, located in Paxtuxent River, Maryland.<br /><br />Learn more about this agency <br /><br /><b>Responsibilities</b><br /><br /><ul> <li>You will advise management regarding the development and delivery of medical necessity determinations and procedures.</li> <li>You will supervise staff in providing referral management services.</li> <li>You will coordinate care and utilization of medical assets need for eligible beneficiaries.</li> <li>You will provide management and review for referral cases in accordance with established organizational protocols.</li> </ul> <br /><br /><b>Travel Required</b><br /><br />Occasional travel – You may be expected to travel for this position.<br /><br />Supervisory status <br /> Yes <br /><br />Promotion Potential <br /> 10 <br /><br /></li> <b>Requirements</b><br /><br /><b>Conditions of Employment</b><br /><br /><ul> <li>Must be a US Citizen.</li> <li>Must be determined suitable for federal employment.</li> <li>Must participate in the direct deposit pay program.</li> <li>New employees to the Department of the Navy will be required to successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit www.dhs.gov/E-Verify/.</li> <li>A SECRET security clearance is a requirement of this position. Failure to obtain and maintain the required level of clearance may result in the withdrawal of a position offer or removal.</li> <li>A favorable ANACI (Access National Agency Check and Inquiries) background investigation is required for noncritical sensitive positions with access to network systems.</li> <li>This is a Department of the Navy drug testing designated position. In accordance with Executive Order 12546, applicants selected are required to submit to a drug test and receive a negative drug test result prior to appointment.</li> <li>This is a Department of the Navy drug testing designated position. In accordance with Executive Order 12546, applicants selected are required to submit to a drug test and receive a negative drug test result prior to appointment.</li> <li>Drug test results will be provided to the employing activity/command. In addition, this position is a drug-testing designated position (TDP) subject to random testing for illegal drug use.</li> <li>In accordance with BUMEDINST 6220.9B, all personnel including direct and indirect care providers, administrators, ancillary services, volunteers, students, and others who may come in contact with patients,</li> <li>must receive and maintain appropriate vaccination against influenza. The incumbent must, as a condition of employment, be immunized on an annual basis against influenza.</li> <li>Occasional overtime work may be required.</li> <li>Complete transcripts include, however are not limited to: student's name, name of educational institution, course title(s), semester/quarter hours, and grade/degree earned to include date(s), as applicable.</li> <li>This is a "Temporary Appointment" temporary appointments may be extended up to three years at the discretion of management and in accordance with applicable regulations.</li> <li>Please refer to the "Required Documents" section for additional information that may be related to this position.</li> </ul> <br /><br /><b>Qualifications</b><br /><br /><strong>BASIC REQUIREMENTS</strong> <br /> Applicants must meet the following Basic Requirements of the Office of Personnel Management (OPM) Qualifications Standards Manual: Applicants must possess:<br /><br />Education <br /> A graduate or higher level degree, bachelor's degree, associate degree, or diploma from an accredited professional nursing educational program is required. This education must have been accredited by the Commission on Collegiate Nursing Education, Council on Accreditation of Nurse Anesthesia Educational Programs, Accreditation Commission for Midwifery Education, or an accrediting body recognized by the U.S. Department of Education at the time the degree was obtained.**Degree from Foreign Nursing School: Official certification from the Commission on Graduates of Foreign Nursing Schools is required for individuals who graduated from foreign nursing schools.<br /><br />Licensure <br /> For all grade levels and positions, applicants must have passed the National Council Licensure Examination. In addition, they must possess a current, active, full, and unrestricted license or registration as a professional nurse from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.Failure to possess the Basic Requirement factors listed above WILL result in an ineligible rating and removal from further consideration for the position.<br /><br />Possession of the requirements must be verifiable via SUBMITTING A COPY of your complete transcripts reflecting your eligible nursing education as noted above AND a copy of your current, active, full, and unrestricted license or registration as a professional nurse from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States with your application.<br /><br /><strong>SPECIALIZED EXPERIENCE</strong> <br /> In addition to the Basic Requirements and Selective placement factors listed above for this position, your resume must also demonstrate at least one year of specialized experience at or equivalent to the GS-09 grade level or pay band in the Federal service or equivalent experience in the private or public sector. Specialized experience must demonstrate the following:<br /><br />- Conducting research and data mining in various healthcare management reporting systems (e.g., Composite Health Care System (CHCS), Referral and Authorization System, or similar healthcare databases) used to collect trend utilization, medical necessity, and referral data.<br /><br />- Performing criteria-based evaluation on a situational basis regarding the medical necessity, relevancy and efficient use of healthcare services, procedures, and facilities.<br /><br />- Researching/reviewing internal and external consultation and referral requests for patient eligibility based on health care plan coverage.<br /><br />- Analyzing/reporting information for utilization, medical necessity and specialty care referral metrics.<br /><br />Additional qualification information can be found from the following Office of Personnel Management website:<br /> https: www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/#url=GS-TECH. <br /><br />https: www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/0600/nurse-series-0610/ <br /><br />Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., professional, philanthropic, religious, 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. <br /><br /><b>Education</b><br /><br />There is no substitution of education for experience for the 0610 series at the GS-10 grade level per the Office of Personnel Management (OPM) qualification standard. <br /><br /><b>Additional information</b><br /><br />This position is covered by the Department of Defense Priority Placement Program.<br /><br />Additional vacancies may be filled by this announcement.<br /><br />A tentative offer of employment will be rescinded if the selectee fails to meet the pre-employment requirements, including failure to report to any of the scheduled appointments.<br /><br />If you are unable to apply online and request information about the Alternate Application process, please contact the Department of Navy's Employment Information Center.<br /><br />Federal annuitant information: The selection of an annuitant is subject to the Department of Defense and Department of the Navy policy on the employment of annuitants. Policy information may be found at: http: www.secnav.navy.mil/donhr/Documents/CivilianJobs/FedCivAnnuitants.pdf <br /><br />ICTAP Applicants: To be considered well-qualified and exercise selection priority as an ICTAP candidate for this vacancy, displaced Federal employees must satisfy all qualification requirements for the position and receive a rating in the highly qualified category or higher. For more information about ICTAP eligibility please review the following link: https: www.usajobs.gov/Help/working-in-government/unique-hiring-paths/federal-employees/ictap/ <br /><br /><b>How You Will Be Evaluated</b><br /><br />You will be evaluated for this job based on how well you meet the qualifications above.<br /><br />In order to qualify for this position, your resume must provide sufficient experience and/or education, knowledge, skills, and abilities to perform the duties of the specific position for which you are being considered. Your resume is the key means we have for evaluating your skills, knowledge, and abilities as they relate to this position. Therefore, we encourage you to be clear and specific when describing your experience.<br /><br />When the application process is complete, we will review your resume to ensure you meet the hiring eligibility and qualification requirements listed in this announcement. You will be rated based on the information provided in your resume and responses to the Occupational Questionnaire, along with your supporting documentation to determine your ability to demonstrate the following competencies:<br /><br /><ul><li>ACCOUNTABILITY</li><li>CARE MANAGEMENT</li><li>CLINICAL ANALYSIS AND JUDGMENT</li><li>EVIDENCE-BASED PRACTICE</li><li>WRITTEN COMMUNICATION</li></ul><br /><br />You will be evaluated and rated under Category Rating selection procedures. Additional points are not added for veterans' preference; however, preference is still applied. Applicants eligible for veteran's preference will receive selection priority over non-veterans. If selected, you may be required to provide supporting documentation.<br /><br />If after reviewing your resume and supporting documentation, a determination is made that you inflated your qualifications and/or experience, your score may be adjusted to more accurately reflect your abilities or you may be found ineligible/not qualified.<br /><br />Please follow all instructions carefully. Errors or omissions may affect your rating or consideration for employment.<br /><br />All qualifications requirements must be met by the closing date of this announcement. <br /><br /><b>Background checks and security clearance</b><br /><br />Security clearance <br /> Secret <br /><br />Drug test required <br /> Yes <br /><br /></li> <b>Required Documents</b><br /><br />A COMPLETE RESUME IS REQUIRED. Your resume must show relevant experience (cover letter optional) where you worked, job title, duties and accomplishments, employer's name and address, supervisor's name and phone number, starting and end dates (Mo/Yr), hours per week & salary. If you are a current Federal employee or previous Federal employee, provide your pay plan, series and grade level i.e. GS-0201-09. Note: Only the last resume received will be reviewed.<br /><br />YOU ARE REQUIRED TO DOCUMENT IN YOUR APPLICATION PACKAGE EVIDENCE THAT SUPPORTS YOUR ELIGIBILITY AND QUALIFICATION CLAIMS. You are required to upload the applicable documents with your application package. These documents will assist the staffing specialist in determining your eligibility and qualifications.<br /><br />DOES THIS POSITION REQUIRE A LICENSE OR CERTIFICATE?<br /> You must submit a copy of your license or certificate in your application package.<br /><br />ARE YOU QUALIFYING BASED ON EDUCATION or A COMBINATION OF EDUCATION AND EXPERIENCE?<br /> You must submit a copy of your college transcript or an appropriate course listing. You may submit a copy of your degree(s) if specific coursework does not have to be verified. Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education. Applicants can verify accreditation at the following website: http: www.ed.gov/admins/finaid/accred/index.html . All education claimed by applicants will be verified by the appointing agency accordingly. If selected, an official/sealed transcript will be required prior to appointment.<br /><br />ARE YOU A VETERAN CLAIMING SOLE SURVIVORSHIP PREFERENCE OR 5-POINT VETERANS' PREFERENCE?<br /> You must provide legible copy/copies of the following: DD-214 (member 4 copy), "Certificate of Release or Discharge from Active Duty," showing all dates of service, as well as character of service (Honorable, General, etc.) or Statement of Service/Proof of Service (in lieu of a DD-214) from your command or local Personnel Support Detachment (PSD). The Statement of Service/Proof of Service must provide all dates of service, the expected date of discharge and anticipated character of service (Honorable, General, etc.). Veterans should upload their DD-214 once they receive it upon separation.<br /><br />ARE YOU A DISABLED VETERAN or CLAIMING 10-POINT VETERANS' PREFERENCE?<br /> Disabled veterans, veterans, widows, spouses or the parent of a veteran who are eligible for 10-point veterans' preference must provide legible copies of the following: Applicable supporting documents as noted on Standard Form-15 (SF-15). To obtain a copy of SF-15, go to http: www.opm.gov/forms/pdf_fill/SF15.pdf .<br /><br />ARE YOU AN ACTIVE DUTY SERVICE MEMBER? Active Duty Service Members are required to submit a statement of service printed on command letterhead and signed by the command. The statement of service must provide the branch of service, rate/rank, all dates of service, the expected date of discharge and anticipated character of service (Honorable, General, etc.).<br /><br />Documents submitted as part of the application package, to include supplemental documents, may be shared beyond the Human Resources Office. Some supplemental documents contain personal information such as SSN and DOB and some documents such as military orders and marriage certificates may contain personal information for someone other than you. You may sanitize these documents to remove said personal information before you submit your application. You may be asked to provide an un-sanitized version of the documents if you are selected to confirm your eligibility. <br /><br /><b>If you are relying on your education to meet qualification requirements:</b><br /><br />Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education . <br /><br />Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.


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