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Program Analyst - Compliance

Veterans Health Administration

Durham, NC

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JOB DETAILS
SKILLS
Administrative Skills, Analysis Skills, Auditing, Billing, Business Operations, Business Processes, Business Solutions, Certified Coding Specialist (CCS), Clinical Medicine, Clinical Nursing, Clinical Validation, Corporate Compliance, Corrective Action, Data Analysis, Data Collection, Department of Veterans Affairs, Develop Methodologies, Documentation, External Audit, Federal Government, Generally Accepted Auditing Standards (GAAS), Government, Government Standards, Healthcare, Healthcare Administration, Healthcare Reimbursement, Human Resources, Insurance, Internal Audit, Leadership, Legal, Maintain Compliance, Medical Records, Onboarding, Operations Security (OPSEC), Organizational Skills, Patient Care, People Management, Performance Analysis, Pharmacy, Physical Demands, Policy Development, Position Papers, Presentation/Verbal Skills, Procedure Development, Process Analysis, Process Management, Program Control, Regulations, Regulatory Compliance, Reimbursement, Reporting Skills, Revenue/Sales Reporting, Risk Analysis, Strategic Planning, Third-Party Payer, Time Management, United States Citizen, Vaccination
LOCATION
Durham, NC
POSTED
Today
Summary

This position is located at the Durham VA Medical Center (DVAMC) in the Corporate Compliance Section. This individual performs functions associated with monitoring, auditing, and data analysis processes that are an integral part of an effective Corporate Compliance Program. Additionally, the individual will be responsible for preparing reports and presentations on monitoring and auditing results for the CCS, medical center staff, and Executive Leadership.

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Duties

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The position is responsible for facility-wide compliance auditing of business operations impacting compliance. Additionally, the position delivers subject matter expertise in billing and coding functions within the facility. Leads internal compliance auditing and conduct external Compliance Auditing Initiatives to support risk assessment plans, Monitoring and Auditing Plan, and Training/Education Plan as it relates to potential and identified facility risks. Briefs leadership and the Compliance Committee on audit findings with recommendations of system changes or corrective actions to address areas of system failure.

The position also serves as the Controlled Substance Coordinator (CSC) and is responsible for managing the Controlled Substance Inspection Program (CSIP) for DVAMC, and ensuring the Medical Center follows VA regulations and mandates. The CSC recommends appointment and release of the inspectors appointed to the CSIP and coordinates, conducts, and ensures the documentation of their training and assignments. The CSC is the principal advisor on issues of organizational compliance and is responsible for providing timely and accurate analytical reports to the Director, Chief of Corporate Compliance, Chief of Pharmacy, Police, Nursing, and other clinical and administrative services as appropriate. Utilizes flow charts, staff interviews, and auditing tools to identify weaknesses within the program, and maintains awareness of laws and regulations (e.g., VHA Handbook 1108.2), keeping appraised of current changes that may affect CSIP. The Position will investigate complaints and findings related to possible diversion activities (e.g., quantity shortage, mail prescriptions not received, etc.), document and report any findings and make improvement recommendations to policies and procedures as necessary.

The position develops procedures and tracking systems for establishing, assessing, and calculating data and information related to administrative, operational, fiscal, and clinical services. These procedures may be applied to audits, inspections, strategic initiatives, research, management decisions, clinical reviews, and performance monitoring. The activities apply to the medical center and results may impact the entire organization from local departments to national levels.

Performs surveys, reviews, and audits, including Veterans Health Administration (VHA) facility and network OIC audits upon request, related program reviews and performance audits, follow-up audits, and special audits generated by high-level administration officials which are in accordance with VHA and generally accepted government auditing standards.

Initiates and develops concepts relating to review and evaluation of health records and related revenue cycle processes, purchased care processes, and business systems. Independently develops audit methodology.

Prepares final reports and audit programs for senior leadership. Prepares, organizes, and completes comprehensive position paper files that include complete summaries of evidentiary data to support conclusions relevant to audit objectives. Gathers information about the assigned organization or single-issue function scheduled for audit and determines the overarching audit objectives.

Examines business processes, related financial records, and controls to obtain sufficient and reliable evidence of business reliability.

The position is responsible for completing programmatic auditing of facility-wide revenue process and non-VA care. Through extensive auditing and tracking, the position ensures that all policies, procedures, and guidance are implemented with respect to facility billing to third party payers (such as insurance carriers).

The position is responsible for validating through formal auditing of payments provided through reimbursement in areas such as Aid and Attendance/caregiver programs to ensure the VHA is only reimbursing for covered services. Upon completion of facility-wide revenue and non-VA care audit reviews/coordination (i.e. Veteran's Community Care documentation/reimbursement review, non-VA care inpatient services), the position develops, coordinates with process owners/facility leadership, and recommends corrective action plans to ensure compliance with billing/reimbursement procedures.

Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level.

Work Schedule: M-F 8-4:30 pm

Compressed/Flexible: Not Authorized

Telework: Ad-hoc

Virtual: This is not a virtual position.

Position Description/PD#: Program Analyst - Compliance/PD502470

Requirements

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Conditions of employment

  • You must be a U.S. Citizen to apply for this job
  • To be considered for this position, you must complete all required steps in the process. In addition to the application and questionnaire, this position requires an online assessment. The online assessment measures critical general competencies required to perform the job.
  • Selective Service Registration is required for males born after 12/31/1959
  • Physical Requirements: The work required does not inherently include any physical requirements essential for successful job performance that could not otherwise be performed with accommodation or workplace adjustment. A pre-placement physical examination is not required.
  • Subject to background/security investigation
  • Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements ( Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
  • Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP)
As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period or 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider:
  • your performance and conduct;
  • the needs and interests of the agency;
  • whether your continued employment would advance organizational goals of the agency or the Government; and
  • whether your continued employment would advance the efficiency of the Federal service.
Upon completion of your probationary period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 07/08/2026.

Time-In-Grade Requirement: Merit promotion applicants must meet applicable time-in-grade requirements to be considered eligible. One year at the GS-07is required to meet the time-in-grade requirements for the GS-09 level.
  • You must submit your SF-50 that shows Time-in-Grade eligibility and reflects your title, series, and grade. No award SF-50 will be accepted; recommended SF-50s include promotions and step increases (within grade increases).
If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade.

You may qualify based on your experience and/or education as described below:
  • Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS 7 in the normal line of progression for the occupation in the organization.
  • Personnel Management's website at


Education

A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit:

Additional information

Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.

Reasonable Accommodation (RA) Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments if you received the link after the close of the announcement. To determine if you need a RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments.

Receiving Service Credit for Earning Annual (Vacation) Leave: 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. VA may offer newly-appointed Federal employee's credit for their job-related 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. Such credit must be requested and approved prior to the appointment date and is not guaranteed.

This job opportunity announcement may be used to fill additional vacancies.

The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced VA competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation (a copy of the agency notice, your most recent performance rating, and your most recent SF-50 noting current position, grade level, and duty location) and be found well-qualified for this vacancy. To be well-qualified: applicants must possess experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the required competencies of the job. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website at

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.



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A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.

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Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.

About the Company

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Veterans Health Administration