HEALTH SYSTEM SPECIALIST (GS-12)

Summary

Click on "Learn more about this agency" button below to view Eligibilities being considered and other IMPORTANT information. The primary purpose of this position is to serve as a TRICARE Health Plan subject matter expert and advocate in support of active duty Exceptional Family Member Program (EFMP) enrolled families.

Duties

Healthcare Plan Subject Matter Expert. Healthcare Plan Family Advocate. Uses a variety of databases and data reports such as Knowledge Exchange, TRICARE On-Line, TRICARE.mil, Share Point, Managed Care Support Contractors Data Sites, Defense Enrollment Eligibility Reporting System (DEERS), Composite Health Care System/Armed Forces Health Longitudinal Technology Application (CHCS/AHLTA), MHE GENESIS, TRICARE Operations Center (TOC), as well as HR case management systems, to analyze data and construct fact-based data driven information and recommendations for the AF EAP Division and Medical Operations Branch.

Qualifications

In order to qualify, you must meet the specialized experience requirements described in the Office of Personnel Management (OPM) Qualification Standards for General Schedule Positions, Administrative and Management Positions, GS-0671 series. SPECIALIZED EXPERIENCE: I have one year of specialized experience equivalent to the GS-11 grade level in the Federal service. Specialized experience must include: Comprehensive knowledge of the missions, programs and requirements of integrated healthcare delivery systems to include regulations, standards, procedures, methods, and techniques to be applied in the DoD and civilian sector. Knowledge of healthcare issues, program goals/objectives and medical administrative procedures to plan, schedule and conduct projects and studies to evaluate and recommend ways to improve the effectiveness/efficiency of health care delivery to exceptional family members. Knowledge of management and organizational principles and practices and comprehensive knowledge of those practices into the healthcare service field. Knowledge of patient administration departmental procedures, medical treatment facility management policies, and familiarity with general principles of health care administration. Knowledge of benefits authorized by public law and regulations, to included knowledge of the TRICARE health plan and contracts. Knowledge of medical records policies and procedures, and understanding of healthcare related privacy laws and policies. Knowledge and skills in statistics, data analysis, and economic principles to apply various methods and techniques for analyzing data for trends, variances and productivity to identify deficiencies to determine effect and impact on AF health plans management and provide consultations to other AF medical staff. Knowledge of and ability to use information management software such as Microsoft Office products, to include Excel. FEDERAL TIME-IN-GRADE (TIG) REQUIREMENT FOR GENERAL SCHEDULE (GS) POSITIONS: Merit promotion applicants must meet applicable time-in-grade requirements to be considered eligible. One year at the GS-11 level is required to meet the time-in-grade requirements for the GS-12 level. TIG applies if you are in a current GS position or held a GS position within the previous 52 weeks. NOTE: Applicants applying as VEOA candidates who are current GS civil service employees or are prior GS civil service employees within the past 52 weeks must also meet time-in-grade requirements. KNOWLEDGE, SKILLS AND ABILITIES (KSAs): Your qualifications will be evaluated on the basis of your level of knowledge, skills, abilities and/or competencies in the following areas: 1. Comprehensive knowledge of the missions, programs and requirements of integrated healthcare delivery systems to include regulations, standards, procedures, methods, and techniques to be applied in the DoD and civilian sector. Knowledge of healthcare issues, program goals/objectives and medical administrative procedures to plan, schedule and conduct projects and studies to evaluate and recommend ways to improve the effectiveness/efficiency of health care delivery to exceptional family members. 2. Knowledge of management and organizational principles and practices and comprehensive knowledge of those practices into the healthcare service field. 3. Knowledge of patient administration departmental procedures, medical treatment facility management policies, and familiarity with general principles of health care administration. Knowledge of benefits authorized by public law and regulations, to included knowledge of the TRICARE health plan and contracts. Knowledge of medical records policies and procedures, and understanding of healthcare related privacy laws and policies. 4. Knowledge and skills in statistics, data analysis, and economic principles to apply various methods and techniques for analyzing data for trends, variances and productivity to identify deficiencies to determine effect and impact on AF health plans management and provide consultations to other AF medical staff. 5. Ability to use information management software such as Microsoft Office products, to include Excel. Understanding of information systems used in Air Force MTFs, to include DEERS, MHE GENESIS, CHCS, and AHLTA. 6. Skill in communicating, both orally and in writing, to provide seasoned consulting to operating managers and other specialists; lead team studies, negotiate complex, controversial issues; provide informational briefings to include options and recommendations to high level management; and establish and maintain effective and positive working relationships. PART-TIME OR UNPAID EXPERIENCE: Credit will be given for appropriate unpaid and or part-time work. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week. VOLUNTEER WORK EXPERIENCE: Refers to paid and unpaid experience, including volunteer work done through National Service Programs (i.e., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; student and social). Volunteer work helps build critical competencies, knowledge and skills that can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.

Education

IF USING EDUCATION TO QUALIFY: If position has a positive degree requirement or education forms the basis for qualifications, you MUST submit transcripts with the application. Official transcripts are not required at the time of application; however, if position has a positive degree requirement, qualifying based on education alone or in combination with experience, transcripts must be verified prior to appointment. An accrediting institution recognized by the U.S. Department of Education must accredit education. Click here to check accreditation. FOREIGN EDUCATION: Education completed in foreign colleges or universities may be used to meet the requirements. You must show proof the education credentials have been deemed to be at least equivalent to that gained in conventional U.S. education program. It is your responsibility to provide such evidence when applying.

How you will be evaluated

Your application package (resume, supporting documents, and responses to the questionnaire) will be used to determine your eligibility, qualifications, and quality ranking for this position. Please follow all instructions carefully. Errors or omissions may affect your rating or consideration for employment. BASIS OF RATING: Your application will be rated under the Cut Point procedures based on the extent to which the quality, depth, and complexity of your experience and education relate to the qualification requirements. Additional points are not added for Veteran's Preference; however, Veteran's Preference is considered where applicable. Best Qualified Group: Candidates in this category possess exceptional skills and experience to exceed well above the minimum requirements Fully Qualified Group: Candidates in this category possess good skills and experience above the minimum requirements. Basically Qualified Group: Candidates in this category meet the minimum education and/or experience requirements. The resume/documents you submit must support your responses to the online questionnaire. If your application contradicts or does not support your questionnaire responses, you will receive a rating of "not qualified" or "insufficient information" and you will not receive further consideration for this job. For additional information on what to include in your resume, click here. APPRAISALS/AWARDS: Hiring Managers use objective methods and consider previous performance appraisals and awards in the selection process. Current Federal Civilian employees should list any relevant performance related rating and/or awards in your resume. Applicants who disqualify themselves will not be evaluated further.

How to apply

The complete Application Package must be submitted by 11:59 PM (ET) on 11/06/2026 To preview the Application Questionnaire, please click the following link: https://apply.usastaffing.gov/ViewQuestionnaire/13107063 To begin the process, click the Apply Online button to create an account or log in to your existing USAJOBS account. Follow the prompts to complete the application questionnaire. Please ensure you click the Submit My Application button at the end of the process. To apply for this position, you must provide a complete Application Package which includes: 1. Your Resume. If you submit more than one resume, only the most recent will be reviewed. The "most recent" is considered the resume with the latest timestamp. Resumes may not exceed two pages. The two-page resume ensures the most relevant experience is reviewed and considered, which is a common practice in both the public and private sectors. Resumes exceeding two pages will be removed from consideration. Additional information on how to complete or update your resume may be located here. For qualification determination your resume must contain hours worked per week and dates of employment (i.e., month/year to month/year or month/year to present). If your resume does not contain this information, your application may be marked as insufficient, and you will not receive consideration for this position. If you are a current Federal employee or previous Federal employee, provide your pay plan, series and grade, i.e. GS-0301-09. Current Federal Civilian Employees may list any relevant performance related rating (given within the last three years) and/or incentive awards in your resume. Do NOT include photographs, inappropriate material, inappropriate content, nor personal information such as age, gender, religion, social security number, etc., on your resume. If the resume you submit contains such information you will not be considered for this vacancy. Your name, first and last, MUST be included on your resume. 2. A complete Application Questionnaire 3. Additional Required Documents (see Required Documents section). Ensure all submitted documents contain your full name. 4. Help recruiters find you. Make your resume and profile searchable, which means recruiters may contact you about possible jobs. Additional information may be located here. PLEASE NOTE: It is the applicant's responsibility to verify that information entered and/or uploaded, (i.e., resume) is received, accurate, and submitted by the closing date. You may verify your documents have been processed with your application package successfully. You can access your USAJOBS account to do so by clicking here. Uploaded documents may take up to one hour to clear the virus scan. Human Resources WILL NOT modify or change any answers submitted by an applicant.

Other information

Interagency Career Transition Assistance Program (ICTAP): For information on how to apply as an ICTAP eligible click here. To be well-qualified and exercise selection priority for this vacancy, displaced Federal employees must be rated well qualified or above for this position. You must submit a copy of the agency notice, your most recent performance rating, and your most recent SF-50 noting position, grade level, and duty location. Employed Annuitants (Reemployed Annuitants): Applicants in receipt of an annuity based on civilian employment in the Federal Service are subject to the DoD Policy on The Employment of Annuitants. Click here for more information. 120-Day Register: This announcement may result in a 120-day register that may be used to fill like vacancies for 120 days after the closing date. Applicants may be referred for consideration as vacancies occur. Military Spouse Preference (MSP) Eligible: MSP applicants, if determined best qualified, must be selected and placed at the highest grade for which they applied. You must include a completed copy of the DD Form 3145-4, Military Spouse PPP Self-Certification Checklist dated within 30 days along with the documents identified on the checklist to verify your eligibility for MSP. Click here to obtain/download a copy of the DD Form 3145-4, Military Spouse PPP Self-Certification Checklist. Priority Placement Program (PPP) Applicant Eligible: PPP Applicants, if determined well qualified and selected, will be placed at the at the full performance level. You must include the applicable completed copy of the PPP Self-Certification Checklist dated within 30 days along with the documents identified on the checklist to verify your eligibility as a PPP Applicant. Click here to obtain/download a copy of the applicable PPP Self-Certification Checklist (DD3145-1 through DD3145-4, select the appropriate checklist for your claimed preference). To determine the applicable PPP Self-Certification Checklist required to substantiate the eligibilities you are claiming, refer to the AF Civilian Employment Eligibility Guide located in the Required Documents section of this vacancy announcement. Direct Deposit: All federal employees are required to have direct deposit. Disabled veteran leave is available to a Federal employee hired on/after 5 Nov 2016, who is a veteran with a service-connected disability rating of 30% or more. For more information, click here. If you have questions regarding this announcement and have hearing or speech difficulties click here.