About this role
Job SummaryAbout the Position: This position is located at West Point, New York. The position works in a building separate from the main hospital but on West Point and is co-located with the call center and the referral center. The hours are an 8-hour work day from 0800-1630 with a 30-min lunch.
QualificationsWho May Apply: Only applicants who meet one of the employment authority categories below are eligible to apply for this job. You will be asked to identify which category or categories you meet, and to provide documents which prove you meet the category or categories you selected. Current Civilian Employees of the Defense Health Agency (DHA) Domestic Defense Industrial Base/Major Range and Test Facilities Base Civilian Personnel Workforce Interagency Career Transition Assistance Plan Land Management Workforce Flexibility Act Military Spouses, under Executive Order (E.O.) 13473 Priority Placement Program, DoD Military Reserve (MR) and National Guard (NG) Technician Eligible Priority Placement Program, DoD Military Spouse Preference (MSP) Eligible Priority Placement Program, DoD MR and NG Preference Eligible Tech Receiving Disability Retirement Priority Placement Program, DoD Retained Grade Preference Eligible Veterans Employment Opportunity Act (VEOA) of 1998 In order to qualify, you must meet the education and/or experience requirements described below. 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; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document. To Qualify for the GS-06: Specialized Experience: One year of specialized experience which includes receiving, investigating, processing, or providing feedback on telephonic or walk-in inquiries concerning medical care provided to beneficiaries through civilian health care facilities or providers. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-05). To Qualify for the GS-07: Specialized Experience: One year of specialized experience which includes reviewing referrals for completeness, accuracy, and compliance; maintaining external care request database ; and using Electronic Health Record(EHR) database or similar program. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-06). Some federal jobs allow you to substitute your education for the required experience in order to qualify. For this job, you must meet the qualification requirement using experience alone--no substitution of education for experience is permitted. Time in Grade Requirement: Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-06). Time in Grade Requirement: Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-05).
Major DutiesCoordinate care through appointing referrals internal to the hospital based on capabilities and capacity and deferring referrals to the network when required.Maintain positive and clear communication with nurse case managers, group practice managers, providers, and the clinical support division to ensure the patients needs and hospital requirements are followed throughout the process.Communicate directly with the patient to address referral concerns and questions and works directly with Humana to resolve any issues.Educate staff, healthcare professionals, and beneficiaries on consult tracking procedures.Gather medical and personal information relevant to program eligibility and beneficiary needs in order to coordinate appropriate care.