SUPERVISORY HEALTH SYSTEM SPECIALIST-AREA

GS-67l-l3

I. Introduction:

This position is organizationally located in the Contract Health
Services Division, Area Office, Indian Health Service. The function of
the Contract Health Services Division is to plan, implement, coordinate
and monitor all contract health services within the Area. The purpose of
this position is to manage the Contract Health Services Division, Area
contract health program and to serve as Area technical consultant for
Area and field managers on all Contract Health Services matters.

II\. Major Duties:

Serves as principal advisor on the Contract Health Services Program on
policy development, interpretation and implementation to Area and
Service Unit staff and professional staff in the private health care
sector. Incumbent is responsible for ensuring that IHS and Area
regulations, policies and procedures relating to Contract Health
Services are executed. Develops new program guidelines and policies as
required and represents IHS in meetings with other federal, state and
local officials, tribal organizations, educational institutions and
other private health care providers to develop health care resources and
to convey an understanding of the Contract Health Services Program.

Incumbent works with Headquarters, Area Office and Service Unit
professional staff on comprehensive program planning to insure that CHS
Program is effectively integrated into a comprehensive health care
delivery system. Incumbent works with Tribal groups in the redesignation
of CHS Delivery Areas which affects CHS funds, the number of people
served and patient eligibility.

Incumbent independently defines, and develops contract requirements and
serves as lead negotiator in negotiation of contracts with private
vendors. Determines reasonableness of rates obtained for all health
services through periodic review of prevailing rates obtained from such
sources as insurance intermediaries, V.A. fee schedules and Title 19
Program.

Incumbent responds to all CHS inquiries and requests for health care
assistance including highly complex, extensive and sensitive
Congressional inquiries. Such requests invariably originate from distant
locations and require coordination with other IHS Areas, other Federal
and state agencies, private hospitals, and other health care providers.

Assures equitable distribution and management of CHS funds allocated to
the Area or collected through Third party alternate resources. Through
funds expenditure analysis and knowledge of changing health care
requirements, monitors CHS Program spending plans, funds status
throughout the Area and recommends adjustments as needed

Assigns, schedules, and directs the work assignments to Contract Health
Specialist(s) and clerical support. Determines the nature and complexity
of the work to be performed and the relative priorities involved, the
capabilities of the employees relative to the existing workload and
availability of staff. Provides both technical as well as administrative
supervision including leave approval, performance appraisal, counseling,
disciplining and selection of employees. Actively supports and complies
with current EEO policies and guidelines.

Performs other related duties as assigned.

III\. Factors:

1\. Knowledge required by the position: Knowledge of Contract Health
Services Delivery policies, procedures and guidelines.

Knowledge of direct health care delivery systems.

Knowledge of rate determination sources and methods.

Knowledge of third party alternate resource methodologies.

Knowledge of federal laws pertaining to health care delivery.

Knowledge of health care financing. Knowledge of sound management and
supervisory skills. Knowledge of managed care principles. Knowledge of
acquisition/contracting methodologies. Knowledge of negotiation methods.
Knowledge of EEO Policies and Regulations.

2\. Supervisory Controls: The incumbent is under the general supervision
of the Associate Area Director, who provides direction by broadly
defining, goals and objectives to be achieved. The incumbent proceeds
independently to execute assignments receiving only administrative
supervision.

Recommendations made by the incumbent are accepted almost without
exception. Work is reviewed primarily in terms of results achieved.

3\. Guidelines:

Guidelines include Federal, State, and local laws as well as IHS
Circulars and procedural manuals. The incumbent uses independent
judgment in interpreting and adapting broad guidelines to specific
situations. The incumbent develops local CHS policies and procedures and
uses independent judgment in their application.

4\. Complexity:

Work consists of analysis, and evaluation of interrelated issues of
substantive CHS program I issues. Work requires developing detailed
plans for long range implementation of programs and developing criteria
for evaluating their effectiveness. Work is difficult to analyze due to
changing health care needs as well as rapid changes in legislative and
regulatory requirements. The subjective nature of the work includes
value judgments and predictive measurement requirements used in multi
disciplinary matters ranging from health care financing to clinical
situations.

5\. Scope and Effect:

This position is the focal point for advice and guidance for the CHS
Program. The purpose of the work is to provide the full range of
assessment needs and planning for care. Failure to properly plan,
evaluate and monitor activities of the Contract Care Program would
result in a material weakness of a most grievous nature both in funding
as well as in clinical health care delivery.

6\. Personal Contacts:

Incumbent comes into contact with not only employees within the CHS
Division but also with a wide diversity of outside groups and
individuals including other Federal, State and Local agencies, private
sector health care delivery systems, insurance carriers and
intermediaries, private vendors, congressional staff and a host of
others.

7\. Purpose of Contacts:

The purpose of contacts include negotiations for fee, fee assessment,
program evaluation, and information dissemination. In a majority of
instances contacts are fraught with disagreement, controversy and
adversity both from the provider as well as the patient. This requires
considerable tact and demeanor on the part of the incumbent.

8\. Physical Demands:

The work of the position requires little in the way of physical
exertion.

9.  Work Environment:

> Work is performed primarily in an office and clinical setting with
> minimum exposure to disease.

EVALUATION STATEMENT

Position: SUPERVISORY HEALTH SYSTEMS SPECIALIST, GS-671-13

Organizational Location: Contract Health Services Division, IHS Area
Office.

Standards Referenced: OPM PCS for Health Systems Specialist, GS-671,
12/79; Grade Level Guide for the Evaluation of Program Specialists;
Health System Administration, GS-670-12/79; IHS Classification Guide for
Contract Health Positions 9/88.

Title and Series Determination:

Subject position serves as the CHS division director and provides CHS
technical consultation to managers and staff in an Area Office of IHS.
Work involves planning, analysis, monitoring and evaluation of a Health
Care Delivery System which meet the series definition coverage criteria
depicted in the cited GS-671 position classification standard. Since the
position contains supervisory assignments, the position is appropriately
titled Supervisory Health Systems Specialist in accordance with titling
instructions in cited standard.

Title and Series Allocated: Supervisory Health Systems Specialist,
GS-671-13.

Grade Level Determination:

The Guide for the Evaluation of Program Specialist positions describes
grading criteria for grade levels GS-9 through GS-13.

This Indian Health Service position is compared to the GS-12/13 criteria
as follows:

-   Typical example of a GS-12 level assignment would be the total
    operation of an established program administered by state and local
    community agencies to identify the nature and source, both of
    problems and of successful operation practices in all areas of
    operation e.g., competency of staff, organizational structure,
    resources, with other agencies and organizations.

-   As to level of responsibility, the Supervisor provides guidance to
    the GS-11 or GS-12 program specialist(s). Or a higher level program
    specialist during the time they are working on a complete project or
    program.

-   Positions at the GS-13 Grade Level are responsible for developing
    program material at the Area, Regional or National level. This
    position acts as a consultant to the Area Director and Management
    Staff in the Contract Health Service function and is considered to
    be characteristic of the GS-13 level of responsibility depicted in
    the cited Guide. Comparison of subject position with the GS-685,
    GS-343 and the DHHS Position Classification Guide for CHS positions
    all of which support the GS-13 allocation.

Conclusion: Supervisory Health System Specialist GS-13.

/S/

Vernon E. Hohmann

Position Classification Specialist, IHS

April 5, 1994