Supervisory Medical Benefits Systems Officer

This position is located in the Department of Labor (DOL), Office of Workers' Compensation Programs (OWCP), Division of Administrative Operations (DAO), Branch of Medical and Standards & Operations (BMSO).

Duties

• Provide oversight and direction regarding the development, implementation, and operation of the Office of Workers Compensation Programs (OWCP) medical bill processing/provider network operations, and related functions and activities (e.g., claimant and provider inquiries, provider outreach, and fiscal operations).
• Supervise a staff of Federal professional employees and oversee large, complex bill process operations acquired through contracted services. Provides oversight, and advice that requires exceptional coordination and integration of a number of complex program segments for professional technical, or administrative work.
• Serve as a senior advisor by providing sound counsel and authoritative recommendations to the Branch Chief, Division Director, Deputy Director, and other senior officials regarding medical bill processing/provider network operations. In this capacity, the incumbent functions as the Project Manager (PM) with overall responsibility for managing broad and highly complex projects and employs strategic planning methods and technical advisory services through discussion of overall and specific problems, which may be precedent-setting, extremely involved, or very unusual, with senior executives and program managers.
• Function as the Project Manager (PM) or designate and oversee a PM, with overall responsibility for managing broad and highly complex projects and employs strategic planning methods and technical advisory services through discussion of overall and specific problems, which may be precedent-setting, extremely involved, or very unusual, with senior executives and program managers.
• Oversee customer experience (CX) efforts that include medical bill processing, provider, claimant and pharmacy benefits management perspectives. Ensure medical bill processing services are provided in accordance with industry standard approaches, in a professional, respectful, and compassionate manner that ensures equitable access to services for all claimants.
• Apply mastery project management skills to effectively develop, schedule, coordinate, and administer projects and resources to include monitoring and inspecting costs, work, and contractor performance. Define and establish project scope, requirements, and deliverables as well as short- and long-term system objectives.

For the GS-15, applicants must have 52 weeks of specialized experience equivalent to at least the next lower grade level, GS-14 in the Federal Service.

Specialized Experience is the experience that equipped the applicant with the particular knowledge, skills, and abilities (KSA's) to perform the duties of the position successfully, and that is typically in or related to the position to be filled. To be creditable, specialized experience must have been equivalent to at least the next lower grade level.

Specialized experience for this position is defined as the following:

• Experience overseeing the processing of medical bills, ensuring compliance with healthcare billing standards, regulations, and best practices AND,
• Overseeing the planning, development, and implementation of initiatives to improve or modernize medical/healthcare billing systems, processes, and/or provider networks.