Beneficiary Service Representative (PEBLO) Community, Social Services & Nonprofit - Sheppard Afb, TX at Geebo

Beneficiary Service Representative (PEBLO)

Empowered Management Solutions Empowered Management Solutions Sheppard AFB, TX Sheppard AFB, TX Full-time Full-time $34.
50 - $39.
00 an hour $34.
50 - $39.
00 an hour BENEFICIARY SERVICES REPRESENTATIVE (PEBLO) SUMMARY.
This individual serves as the Physical Evaluation Board Liaison Officer (PEBLO) for the medical treatment facility (MTF) and its geographic area of responsibility.
Provides Disability Evaluation System (DES) guidance in accordance with established DoD guidelines, , data collection, medical coordination, Service member/commander/stakeholder advising, and procedural work related to Medical Evaluation Board (MEB) processing and Temporary Disability Retired List (TDRL) reevaluations in accordance with applicable instructions, regulations and directives.
Liaison support is provided to active duty and Reserve Component (RC) members and commanders on program requirements, military benefits, legal rights, and the appeals process.
Coordinates Aeromedical evacuation or other patient travel requirements, fitness for duty determinations, line of duty (LOD) and other program requirements related to the DES.
Provides Physical Evaluation Board (PEB) findings to service member and medical staff.
Tracks each DES case from referral to final disposition.
Guides the Service member throughout the DES process.
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Qualifications:
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Mandatory knowledge and skills.
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Ability to plan, organize, and manage functions and staff within an MTF to meet program objects.
Knowledge of the military healthcare organizational structure, major issues, policies, procedures and operations related to the management of the healthcare delivery systems.
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Possess in-depth knowledge, experience, and training to handle and solve complex cases that arise when addressing fitness for duty or physical disability evaluation issues.
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Demonstrate tact, diplomacy, and restraint in counseling and explaining entitlements, benefits, and responsibilities to all customers.
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Possess effective interpersonal communication skills to effectively accomplish the IDES process 1.
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Demonstrate mastery of oral and written communication and customer service principles, methods, practices and techniques analytic methods, to include using research tools and statistical analysis and, interpersonal relations practices.
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Ability to communicate effectively both orally and in writing to motivate, train, and work effectively with a diverse workforce.
Must be able to draw realistic conclusions and recommend viable solutions.
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Ability to gather data from various sources, analyze data, statistical analysis, prepare statistical reports and recommendations for improvements.
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Skill in applying fact finding, analytical, and problem solving methods and techniques.
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Knowledge of DES processing regulations, instructions, procedures, and policies to assure timely case processing.
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Practical knowledge and understanding of the TRICARE program.
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Education.
Associate Degree in business administration, management or health care organizations from an accredited college or university.
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Experience.
Two years' experience as a PEBLO within the DoD military health system in the last 6 years; or five years' experience working in a civilian disability program; or two years' experience as a VA Medical Service Coordinator (MSC).
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Work Environment/Physical Requirements.
The work is primarily sedentary.
Requirements include prolonged walking, standing, sitting or bending.
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UNIQUE MILITARY HEALTH CARE COMPUTER SYSTEMS/PROCEDURES:
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The IDES support team will provide ongoing IDES training guidance.
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PEBLO training will include:
Orientation training, on-the-job training, standardized DES annual refresher or continuing education and training to ensure PEBLOs remain current in their understanding and application of DES procedures.
Training will be accomplished via computer- based training, monthly DCS teleconference, and ongoing email communications.
May be required to travel for IDES training workshop at the Government's discretion every two years; travel and reimbursement is in accordance with task order requirements.
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Training will be in accordance with Warrior Care Policy Training Standards and Performance Objectives Guidebook.
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Veteran Tracking Application training will be provided by the Veterans Benefits Administration (VBA/DoD Collaboration Team) via DCS training.
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Regulatory Guidance:
DoDM 1332.
18 Vol 1, Disability Evaluation System (DES) Manual:
General Information and Legacy Disability Evaluation System (LDES) Time Standards, Enclosure 5, DoDM 1332.
18, Vol 2, Disability Evaluation System (DES) Manual:
Integrated Disability Evaluation System (IDES), Enclosure 4 and service-specific regulations, TRICARE Operations and Patient Administration Functions, Section 4K - Medical Evaluation of Service Members (SM) for Continued Military Service.
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PERFORMANCE OUTCOMES:
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Responsible for making initial contact as the principal point of contact between the military member or Next of Kin (NOK), unit commanders, Recovery Care Coordinators, Veteran Affairs (VA) Medical Service Coordinators (MSC) and the boards of the Air Force disability evaluation system at the USAF Physical Disability Division.
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Prepares case file packages and provides to board members for adjudication.
Informs member of the board results and available options.
Ensures everyone completely understands all phases of the process and documents their acknowledgment of understanding.
Provides counseling and direction to all Uniformed Service personnel, or their next of kin (NOK) when deemed necessary.
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Coordinates disability case processing actions.
Collects medical records and other related documents required for Medical Evaluation Board (MEB) and Informal PEB (IPEB) processing following notification by attending physician regarding member's requirement to undergo evaluation to determine physical fitness for retention in duty status.
Refers the prospective evaluee to the Airman Family Readiness Center (AFRC) for pre-separation counseling.
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Obtains a statement from the member's immediate commander describing the impact of the member's medical condition on the member's ability to perform his/her military duties.
Prepares required documents, ensuring the entries on the applicable forms are complete and the DES case file is properly assembled and includes all the necessary supporting documents.
Provides disability counseling to the evaluated member.
Translates PEB findings and recommendations into terms the member can readily understand.
Notifies the MPF of members returned to duty with Assignment Limitation Code-C (ALC-C).
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Counsels members regarding unfit findings by the PEB to include all the ramifications, and recommended disposition.
Explains to the member the effect of the disposition, outlining the various benefits and privileges of retired status if the recommended disposition is Permanent Disability Retirement List (PDRL) or placement on the Temporary Disability Retirement List (TDRL), as well as entitlements lost if member is discharged.
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1 Informs the service member on the availability of legal counsel, briefs the appellate process, and assists in the preparation of requests for appeals, rebuttals, and impartial medical reviews.
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Provides assistance in the preparation and submission of impartial reviews, written appeals, statement, or rebuttals.
Initiates process for arranging member's attendance to the Formal PEB (FPEB), and provides member with current information on FPEB location, lodging, transportation, meals and other pertinent information as provided in established guidelines.
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Provides counseling and direction to all Uniformed Service personnel, or their next of kin (NOK) when deemed necessary.
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Provides weekly updates to the MDG executive staff on pending MEB cases and seeks MDG/CC assistance when necessary.
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Briefs MDG medical providers on the MEB and TDRL process upon assignment to the medical group.
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Serves as the primary contact for DES.
Provides oversight of the execution of DES policies in accordance with federal statutes, DoD regulations, and military inspection agencies.
Interprets and translates DoD and AF/SG policies and procedures.
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Coordinates Line-of-Duty requirements; monitors the Veterans Tracking Application, patient appointing, beneficiary eligibility and entitlement determination, status of DES case management between the Veterans Administration, Air Force Personnel Center (AFPC) and Air Force Medical Operation Agency (AFMOA).
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Coordinates with the referring provider, Director of Medical Services (SGH), or Director of Aerospace Medicine to ensure the local process supports effective DES processing.
Briefs local leaders and higher headquarters on DES limiting factors experienced locally.
Consults with responsible functional representatives to determine causes of DES deviations, adverse trends and related impacts to determine actions to be taken or recommended to improve performance outcomes.
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1 Discloses medical information to authorized personnel in accordance with Privacy Act of 1974 and Health Insurance Portability and Accountability Act (HIPAA) guidelines.
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Identifies and recommends areas of improvement related to established processes/methods.
Develops methods to monitor appointing access timelines as required to maintain awareness of access-to-care availability, which includes recognizing appointing limitations and formulating alternative actions to ensure DES case processing continues to meet timely completion and accuracy requirements.
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1 Develops methods to define process prerequisites and actions to effectively complete pre- DES, referral stage, and Medical Evaluation Board phases of the DES.
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Identifies challenges that could lessen the effectiveness of the DES; e.
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, accurate and timely completion of the narrative summary.
Develops methods to identify possible health system processes that could impede DES processing and implement procedures to minimize or limit the impact.
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1 Develop methods to identify members entering the DES and methods to monitor those returned to duty, but require annual re-evaluation, ensuring annual assessment are accomplished within DoD established timelines.
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2 Identifies and resolve complex DES case issues; e.
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, cases involving Invisible Wounds of War airmen.
Maintains awareness of all cases to oversee or facilitate required actions to meet established DoD and Air Force (AF) guidelines.
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3 Conducts, or participates in conducting, studies related to DES processes; e.
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, work measurement, methods and procedures, timeliness of DES case completion and accuracy, and historic reviews, as requested by DoD, AF/SG, or AFMOA.
Uses knowledge of the rules, regulations, and guidance governing the DES along with various analytical techniques to verify proper management and monitoring of DES cases, timeline completions, and DES stakeholders performance data.
Analysis is based on knowledge of the Defense Enrollment Eligibility Reporting System (DEERS), electronic health records, medical data repositories, military personnel system and VA data system and how those systems interact.
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Gathers information; e.
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, appointment availability, DES completion timelines, VA examination completions, and any issues that may have an impact on the effectiveness of DES processing, from multiple internal and external data sources; e.
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, standard automated information retrieval systems and reports, internet-based sources, ad hoc reports, and interviews with personnel both within and outside the MTF.
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1 Analyzes data related to both timeliness of DES case completion and accuracy of cases presented for adjudication.
The contents/results are crosschecked, validated, analyzed, and interpreted by the employee.
Uses comparative statistics, methods, and analysis, which involves identification and development of major health care indices for trend comparison of Military Health System (MHS) data, by itself or relative to government health care programs, as well as benchmarking of DoD, MHS, or other federal medical facilities performance data.
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Identifies trends and patterns, problem areas and causal relationships, and develops alternative courses of action necessary to meet DES processing plan objectives and standards.
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1 Develops recommendations and prioritization for problems in performance, productivity, effectiveness, and efficiency to support timeliness and accuracy of case processing.
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Maintains currency of DES regulations and PEBLO Guide and educates MTF staff and various beneficiary groups, on changes to those provisions.
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Recommends changes in procedures, as needed, to maintain compliance with applicable regulations.
Stays knowledgeable of locally available programs and organizations that provide assistance and support for service members and their family members concerning physical and medical evaluation boards.
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Schedules and gives presentations to various beneficiary groups at commanders' calls, town hall meetings, and any other forum requiring DES information to include retirement/separation briefings concerning benefits and entitlements.
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Administers an information sharing program to distribute DES information to beneficiaries, the MTF staff, and serviced population about the DES program.
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Prepares pamphlets, briefings, and articles for newspapers and/ or other local media, bulletins, fact sheets, or any other channels to provide information to the serviced population.
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Attends meetings and prepares status reports, as required, on ongoing activities for sectional leadership and others within the duty section.
Prepares agenda and content and conducts DES training for providers and other MTF staff who participate in medical board processing.
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20 Certifications:
HCWs shall maintain current certification in one of the following:
American Heart Association Basic Life Support (BLS) for Healthcare Providers or American Heart Association Healthcare Provider Course.
Other certifications may be acceptable if specified in the contract.
Certification cards must display the American Heart Association or Military Training Network emblem.
-Web-based classes do not meet required standards.
Requirements for Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), Neonatal Resuscitation Program (NRP), Advanced Trauma Life Support (ATLS) or other certifications, shall be specified in the specific contract.
Certification may be available at the MTF on a space available basis; however, the Contractor shall not bill, and the Government shall not pay, for any time HCW's spend in or for certification training.
Failure of the HCW to obtain training on a space available basis does not release the Contractor from the contract requirement Job Type:
Full-time Pay:
$34.
50 - $39.
00 per hour Expected hours:
40 per week
Benefits:
401(k) 401(k) matching Dental insurance Flexible schedule Health insurance Life insurance Paid time off Vision insurance Schedule:
8 hour shift Monday to Friday Work Location:
In person 401(k) 401(k) matching Dental insurance Flexible schedule Health insurance Life insurance Paid time off Vision insurance 8 hour shift Monday to Friday.
Estimated Salary: $20 to $28 per hour based on qualifications.

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