Health System Specialist (Risk Management)

Duties
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• Investigates, analyzes, and processes all provider adverse actions, medical malpractice claims, and active duty death/disability cases in accordance with federal and Department of Defense regulations.
• Acts as the principal consultant for the healthcare system on risk management, interpreting complex laws (e.g., Federal Tort Claims Act), DHA directives, and accreditation standards to provide authoritative guidance to leadership and staff.
• Utilizes healthcare data systems (like JCCQAS and NPDB) to collect, validate, and analyze patient safety, claims, and provider outcome data to identify systemic risks, patterns, and performance trends.
• Creates comprehensive reports, summaries, and briefings based on data analysis, presenting findings and actionable recommendations to leadership to mitigate risk and inform strategic decision-making.
• Directs or participates in intensive clinical investigations and root cause analyses for sentinel events and other serious patient safety incidents to identify contributing factors and develop effective corrective action plans.
• Drafts, reviews, and implements local policies, procedures, and clinical guidance related to risk management and patient safety to ensure alignment with national standards and legal requirements.
• Monitors organizational activities and processes to ensure compliance with the risk management and patient safety standards required by accrediting bodies such as The Joint Commission and the National Committee for Quality Assurance (NCQA).

Requirements
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Conditions of employment

• Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation.
• This position requires the incumbent be able to obtain and maintain a determination of eligibility for a Secret security clearance or access for the duration of employment. A background investigation and credit check are required.

Qualifications

Who May Apply: US Citizens

In order to qualify, you must meet the 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 .

Specialized Experience: One year of specialized experience which includes administering healthcare risk management program activities such as provider adverse action or medical malpractice claim review; AND providing advisory services to leadership based on the interpretation of federal regulations or DOD directives; AND utilizing healthcare data systems to perform trend analysis of risk management data; AND developing reports for leadership review with recommendations based on healthcare risk management data analysis . This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-12).

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.

Education

This job does not have an education qualification requirement.

Additional information

• Male applicants born after December 31, 1959 must complete a Pre-Employment Certification Statement for Selective Service Registration.
• You will be required to provide proof of U.S. Citizenship.
• One year trial/probationary period may be required.
• Direct Deposit of Pay is required.
• Selection is subject to restrictions resulting from Department of Defense referral system for displaced employees.
• Salary negotiation may be available for those candidates who are new to Federal service.
• Leave accrual negotiation may be available for those candidates who are new to Federal service.
• Multiple positions may be filled from this announcement.
• Salary includes applicable locality pay or Local Market Supplement.
• If you have retired from federal service and you are interested in employment as a reemployed annuitant, see the information in the Reemployed Annuitant information sheet.
• Payment of Permanent Change of Station (PCS) costs is not authorized, based on a determination that a PCS move is not in the Government interest.