Contact Representative
Indian Health Service, Camp Verde, AZ, United States
Summary
At the Indian Health Service, Contact Representatives in Purchased Referred Care ensure patients receive timely access to medically necessary services. They determine eligibility, coordinate alternate resources, and safeguard limited healthcare funds while upholding federal regulations. You play a vital role in connecting American Indian and Alaska Native patients to care.
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Duties
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Serves as a Contact Representative in Purchased Referred Care administering eligibility determinations in accordance with federal regulations and IHS policy. Conducts detailed interviews with patients and families to verify eligibility for PRC and alternate resources such as Medicare, Medicaid, VA, and private insurance. Issues medical authorizations or denial letters, ensures funds availability prior to obligation, and maintains fiscal controls in compliance with federal requirements. Researches complex cases, interprets regulations, prepares reports, and serves as liaison with providers, tribal entities, and federal, state, and local agencies to ensure continuity of care and appropriate use of funds. All Grade levels MAY NOT be available at all locations.
Requirements
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Conditions of employment
Selectee may be subject to a probationary period
ESEP appointees typically serve a two year trial period
U.S. Citizenship is required
Selective Service Registration is required for males born after 12/31/1959
This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children. Due to this requirement, the agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes.
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/.
Selectee(s) are required to have a viable bank account at a financial institution for electronic direct deposit of salary payment.
Background Investigation Requirement:
This position requires the successful completion of a federal background investigation as a condition of employment.
A background investigation is a standard process used by the Federal Government to verify an individual's identity, employment history, education, and other relevant information to determine suitability for Federal service.
Upon receipt of instructions, applicants must complete all required background investigation forms within five (5) calendar days of issuance. Timely completion is critical to avoid delays in processing or a determination of unsuitability.
Applicants are strongly encouraged to prioritize this requirement and to maintain regular communication with their assigned Personnel Security Specialist throughout the process.
Financial Suitability Requirement:
This position requires a review of the applicant's financial history as part of the personnel security and suitability determination. Applicants must demonstrate financial responsibility, maintain good standing with creditors, and satisfy all legal financial obligations prior to applying.
Individuals with substantial delinquent or unresolved financial obligations-including, but not limited to, delinquent federal or state tax liabilities, defaulted federal student loans, court-ordered fines or fees, or child support arrears-may be deemed unsuitable for employment with the Indian Health Service (IHS).
Qualifications
To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying.
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; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week.
MINIMUM QUALIFICATIONS:
GS-07:
Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-06 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Experience reviewing and evaluating applications and supporting documentation to make eligibility determinations under established program guidelines. Experience researching applicable policies, analyzing documentation to resolve discrepancies, and making approval or denial decisions based on established criteria. Experience conducting interviews and coordinating with applicants, providers, or external agencies to obtain required documentation and independently manage assigned caseloads.
Time In Grade
Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP).
You must meet all qualification requirements within 30 days of the closing date of the announcement.
Education
There are no education requirements.
Additional information
Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. IHS may offer newly-appointed Federal employees credit for their directly related previous non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave.
This position may be covered by a Bargaining Unit.
Recruitment or relocation incentives may be authorized. A service agreement will be required.
You will be evaluated for this position in accordance with the OPM Merit Hiring Plan.
As part of the application process, you will be asked to provide short essay responses (200 words or less each) to the following four questions.
How has your commitment to the Constitution and the founding principles of the United States inspired you to pursue this role within the Federal government? In this role, how would you use your skills and experience to improve government efficiency and effectiveness? How would you help advance the President's Executive Orders and policy priorities in this role? How has a strong work ethic contributed to your professional, academic or personal achievements? Your responses are optional and will not be scored. However, they may be reviewed by hiring managers and agency leadership (or designees) during the evaluation process. You will be asked to certify that your responses are written in your own words and that you did not use a consultant or artificial intelligence (AI) tool (such as ChatGPT or Copilot). Your application will remain active for 3 months from the date it is submitted. To continue being considered after that period, you must submit a new application.
This is an Open Continuous Announcement. Applications will be reviewed and referred as vacancies occur. This announcement is designed to provide consideration to the greatest number of qualified candidates. Applicants with a complete application will be considered for vacancies that occur during the 3 month period their application remains active or until the announcement closes, whichever occurs first.
There may not be immediate vacancies at all locations. Applicants may select up to 5 locations during the application process and will only be considered for the locations selected. Interested applicants may contact the Human Resources point of contact listed in the announcement regarding current or anticipated vacancies.
Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.
Help
Review our benefits
At the Indian Health Service, Contact Representatives in Purchased Referred Care ensure patients receive timely access to medically necessary services. They determine eligibility, coordinate alternate resources, and safeguard limited healthcare funds while upholding federal regulations. You play a vital role in connecting American Indian and Alaska Native patients to care.
USAJOBS Help Center - Update your resume now so it meets new resume requirements
Learn more about this agency
Duties
Help
Serves as a Contact Representative in Purchased Referred Care administering eligibility determinations in accordance with federal regulations and IHS policy. Conducts detailed interviews with patients and families to verify eligibility for PRC and alternate resources such as Medicare, Medicaid, VA, and private insurance. Issues medical authorizations or denial letters, ensures funds availability prior to obligation, and maintains fiscal controls in compliance with federal requirements. Researches complex cases, interprets regulations, prepares reports, and serves as liaison with providers, tribal entities, and federal, state, and local agencies to ensure continuity of care and appropriate use of funds. All Grade levels MAY NOT be available at all locations.
Requirements
Help
Conditions of employment
Selectee may be subject to a probationary period
ESEP appointees typically serve a two year trial period
U.S. Citizenship is required
Selective Service Registration is required for males born after 12/31/1959
This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children. Due to this requirement, the agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes.
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/.
Selectee(s) are required to have a viable bank account at a financial institution for electronic direct deposit of salary payment.
Background Investigation Requirement:
This position requires the successful completion of a federal background investigation as a condition of employment.
A background investigation is a standard process used by the Federal Government to verify an individual's identity, employment history, education, and other relevant information to determine suitability for Federal service.
Upon receipt of instructions, applicants must complete all required background investigation forms within five (5) calendar days of issuance. Timely completion is critical to avoid delays in processing or a determination of unsuitability.
Applicants are strongly encouraged to prioritize this requirement and to maintain regular communication with their assigned Personnel Security Specialist throughout the process.
Financial Suitability Requirement:
This position requires a review of the applicant's financial history as part of the personnel security and suitability determination. Applicants must demonstrate financial responsibility, maintain good standing with creditors, and satisfy all legal financial obligations prior to applying.
Individuals with substantial delinquent or unresolved financial obligations-including, but not limited to, delinquent federal or state tax liabilities, defaulted federal student loans, court-ordered fines or fees, or child support arrears-may be deemed unsuitable for employment with the Indian Health Service (IHS).
Qualifications
To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying.
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; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week.
MINIMUM QUALIFICATIONS:
GS-07:
Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-06 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Experience reviewing and evaluating applications and supporting documentation to make eligibility determinations under established program guidelines. Experience researching applicable policies, analyzing documentation to resolve discrepancies, and making approval or denial decisions based on established criteria. Experience conducting interviews and coordinating with applicants, providers, or external agencies to obtain required documentation and independently manage assigned caseloads.
Time In Grade
Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP).
You must meet all qualification requirements within 30 days of the closing date of the announcement.
Education
There are no education requirements.
Additional information
Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. IHS may offer newly-appointed Federal employees credit for their directly related previous non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave.
This position may be covered by a Bargaining Unit.
Recruitment or relocation incentives may be authorized. A service agreement will be required.
You will be evaluated for this position in accordance with the OPM Merit Hiring Plan.
As part of the application process, you will be asked to provide short essay responses (200 words or less each) to the following four questions.
How has your commitment to the Constitution and the founding principles of the United States inspired you to pursue this role within the Federal government? In this role, how would you use your skills and experience to improve government efficiency and effectiveness? How would you help advance the President's Executive Orders and policy priorities in this role? How has a strong work ethic contributed to your professional, academic or personal achievements? Your responses are optional and will not be scored. However, they may be reviewed by hiring managers and agency leadership (or designees) during the evaluation process. You will be asked to certify that your responses are written in your own words and that you did not use a consultant or artificial intelligence (AI) tool (such as ChatGPT or Copilot). Your application will remain active for 3 months from the date it is submitted. To continue being considered after that period, you must submit a new application.
This is an Open Continuous Announcement. Applications will be reviewed and referred as vacancies occur. This announcement is designed to provide consideration to the greatest number of qualified candidates. Applicants with a complete application will be considered for vacancies that occur during the 3 month period their application remains active or until the announcement closes, whichever occurs first.
There may not be immediate vacancies at all locations. Applicants may select up to 5 locations during the application process and will only be considered for the locations selected. Interested applicants may contact the Human Resources point of contact listed in the announcement regarding current or anticipated vacancies.
Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.
Help
Review our benefits