Senior Medical Access & Care Coordinator

U.S. Department of Veterans Affairs; San Diego (CA); On-site; USD 60,000 - 75,000; Full time

Job description

Summary

The Advanced Medical Support Assistant (AMSA) works for VA Community Care (VACC) within the VA San Diego Healthcare System. The incumbent has a foundational role within the VHA Non-VA Purchased Care Model transformation initiative. The incumbent has a important role as he/she interfaces and collaborates with larger health care system providers - which include VA and community-based specialists - hospitals - diagnostic and treating facilities - and community-based programs.

Qualifications

Basic Requirements:

• United States Citizenship
• Be a citizen of the United States (U.S.)
• Non-citizens may be appointed when it is not possible to recruit qualified citizens according to 38 U.S.C.
• 7407(a)
• English Language Proficiency
• MSAs must be proficient in spoken and written English in accordance with 38 U.S.C.
• 7403(f) Experience
• One year of creditable experience equivalent to the next lower grade
• Education
• High school diploma - General Education Development equivalency certificate - or proficiency certificate from a State or territorial-level Board or Department of Education
• Grandfathering Provision
• Employees in VHA in this occupation - under a permanent - appropriate - and legal placement on the effective date of the qualification standard - are considered to have met all qualification requirements for the grade and/or assignment held - including positive education and registration/certification where applicable
• For employees who do not meet all the basic or assignment-specific requirements in this standard but met the qualifications applicable to the position at the time they were appointed - the following provisions apply: (1) Employees who are appointed on a temporary basis prior to the effective date of the qualification standard may not have their temporary appointment extended or be reappointed on a temporary or permanent basis until they fully meet the basic requirements of the standard
• (2) Employees retained in this occupation under this provision who subsequently leave the occupation lose protected status and must meet the full VA qualification standard requirements in effect at the time of re-entry to the occupation
• NOTE: This provision is not intended to regularize appointments/ placements
• Grade Determinations: Medical Support Assistant (Advanced) - GS-6. Experience: One year of creditable experience equivalent to the next lower grade - GS-5. The GS-5 is the full performance level for MSAs
• Experience includes: independently performs a full range of duties related to the delivery of health care services in an inpatient or outpatient setting
• Advises clinical staff on current administrative processes
• Responsible for answering phones - greeting patients - relaying messages to appropriate staff inside or outside of the unit - and scheduling appointments - including interpreting and verifying provider orders in accordance with VHA national 8 scheduling guidelines
• Assignments include - but are not limited to: scheduling - canceling - re-scheduling patient appointments and consults
• entering no-show information
• monitoring appointment requests from multiple electronic sources
• participating in huddles to determine the daily needs of the clinic - monitoring both inpatient and outpatient appointments in areas of responsibility
• verifying and updating demographics and insurance information when patients check-in for appointments
• Knowledge - Skills - and Abilities (KSAs)
• In addition to the experience above - the candidate must demonstrate the following KSAs: Advanced knowledge of the technical health care process (including - but not limited to - scheduling across interdisciplinary coordinated care delivery and/or care in the community models and patient health care portals) as it relates to access to care
• Advanced knowledge of policies and procedures associated with interdisciplinary coordinated care delivery and/or care in the community operational activities that affect patient flow - and patient support care administrative functions to include - but not limited to appointment cycles - outside patient referrals - follow-up care - overbooking - provider availability - etc
• Advanced knowledge of medical terminology due to the technical nature of language utilized by clinicians
• Ability to collaborate and communicate with a wide range of medical clinicians across multiple disciplines (e.g. - medical doctors - nurse practitioners - physician assistants - psychologists - psychiatrists - social workers - clinical pharmacists - and nursing staff) to accomplish team goal setting to ensure medical care to patients is met
• Ability to independently set priorities and organize work to meet deadlines - ensuring compliance with established processes - policies - and regulations
• Ability to communicate tactfully and effectively - electronically - by phone - in person - and in writing - with internal and external customers
• This may include preparing reports in various formats and presenting data to various organizational levels - as well as resolving patient concerns
• Assignment
• For all assignments above the FPL - the higher-level duties must be of significant scope - administrative independence - complexity - and range of variety as described in this standard at the specified grade level and be performed by the incumbent at least 25% of the time
• At the advanced level - the Medical Support Assistant (Advanced) performs difficult and responsible specialized and expert administrative patient support while working collaboratively in an interdisciplinary coordinated care delivery model
• Work involves specialized administrative judgment and the flexible use of a wide range of clinical flow processes relating to access to care across multiple clinics - specialties - and/or care in the community resources
• Recommend changes to existing clinic procedures based on current administrative guidelines
• Expertise in utilizing numerous advanced patient systems in support of multiple clinics involved in an interdisciplinary coordinated care delivery model
• Coordinates with the patient care team to review clinic appointment availability to ensure that clinic schedules are closely monitored to effectively support the needs of the clinics - and makes adjustments as necessary
• MSAs at this level develop and/or maintain effective and efficient communication with the patient - interdisciplinary coordinated care delivery model teams - VA medical centers - and other agencies (e.g. - assist with communications during the inpatient to outpatient discharge
• communicate with non-VA medical facilities
• prepare correspondence to notify patients of normal lab results
• manage a system for follow-up care such as consults - tests - etc.)
• Other assignments include - but are not limited to: processes incoming patient secure messaging through MyHealthyVet and coordinates with care team as appropriate
• participates in team huddles and team meetings to manage - plan - problem solve - and follow-up with patient care by sharing information and collaborating with the interdisciplinary team
• setting priorities and deadlines - adjusting the flow and sequencing of the work to meet team and patient needs
• identifies incomplete encounters and communicates findings to providers
• as needed
• assists the team to reinforce the plan of care and self-help solutions
• enters appropriate information into the electronic record
• monitors pre-appointment information and/or requirements to assure readiness for patient visit/procedure
• manages patient systems to verify and validate accuracy and resolve issues
• evaluates patient information and clinic schedule lists to determine whether the patient requires an immediate appointment
• informs team members about shared patients (i.e. - those who receive their care at multiple VA centers or those who receive care in the community)
• Preferred Experience: Community Care Experience Reference: For more information on this qualification standard - please visit https://www.va.gov/ohrm/QualificationStandards/
• The full performance level of this vacancy is GS-6. Physical Requirements: The work is principally sedentary
• There is some walking - bending - standing - and carrying of light items - such as papers - and files - which are customary physical demands of the position
• whether you successfully passed required new employee training.

Duties

• This is a high level Advanced Medical Support Assistant (AMSA) position
• As a front line contact with patients and staff - the AMSA sets the tone for perception concerning quality of healthcare services at the VA
• A high degree of tact and diplomacy is required when dealing with veterans who have multiple health problems and who may be frustrated with the administrative process associated with diagnosis and treatment
• A caring - compassionate and sensitive manner is essential when explaining procedures to veterans and family members both in person and on the phone
• The position involves performing clerical duties - customer service and other administrative duties for the proper and timely treatment of patients while also ensuring that appointment schedules are maintained
• The incumbent must assist with access contingency plans by adjusting appointment times - location or dates as well as shift patients to other healthcare locations when necessary
• The work involves the execution of specific rules - regulations - and/or procedures for scheduling - insurance collections - patient access - privacy and confidentiality
• The purpose of the work is to efficiently and expeditiously manage the patient intake process as well as administratively support the staff by coordinating patient processing
• Major duties include - but are not limited to: When records are received - the incumbent will ensure that all necessary health/administrative information are integrated into Computerized Patient Record System (CPRS) through scanning hardware and VistA Imaging software
• Scans and indexes materials accordingly into CPRS VistA Imagining - on a timely basis and within established guidelines
• and makes the proper disposition of documents
• After the scanning and indexing process is completed - the incumbent will review the quality of scanned documents to ensure integrity of scanned images
• The incumbent is responsible for generating pre-authorizations for medical care outside of the VA network of providers and also coordinates the care with multiple VA clinics - community-based providers - and Veterans alike
• The employee schedules medical appointments with community -based providers and documents them in the appropriate VA systems
• The employee monitors all incoming community care consults and tracks their progress through to the collection of medical records resulting in consult closure
• The incumbent must screen/receive phone calls in a courteous and timely manner - determine the nature of requests and provide the information desired using privacy rules and established clinic process
• The employee supports patient safety standards through correct identification
• The incumbent is responsible to urgent or emergent written or faxed requests for medical information from hospitals and/or providers
• Contact professional staff to obtain information necessary to respond to requests when not readily available to the record
• Obtain medical records from community-based providers as requested by providers and/or patients
• Responsible for ensuing VA and community-based records are uploaded to the appropriate community care consult for review by a VA provider
• The incumbent must be able to interpret and communicate requirements of VHA Scheduling Directives and complete accurate scheduling responsibilities: High level of coordination to avoid patients having to make multiple trips to tire clinics whenever possible
• Notifies her/his supervisor when appointment is less than desirable or if an individual patient cannot be scheduled within mandated clinic timeframes
• The AMSA work involves several processes such as recording - reviewing - compiling - and interpreting medical data and information incidental to a variety of patient care and treatment activities
• Variations in work result from changing priorities which frequently depend upon the urgency of the situation
• Incumbent must use a high degree of tack - poise - empathy - diplomacy and compassion dealing with veterans families - caregivers - fellow co-workers and hospital staff
• The duties of this position vary widely requiring utilization of different processes and methods to accomplish this work
• The work involves questioning of patients or their representatives to collect data for administrative processing of medical examinations - making referrals - scheduling - coordinating - and monitoring return appointments for outpatient treatment work-up in compliance with VHA scheduling directives and HIPAA regulations
• Duties are performed in accordance with the following guidelines: verbal/written instructions from supervisor or lead - VA regulations and directives - VISN and local policies and memorandums - public law and other federal and state statutes as they apply
• Work Schedule: Monday-Friday - 7:30am -4:00pm Telework: Not Available Virtual: This is not a virtual position
• Functional Statement #: 000000 Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized