Enter your Social Security Number in the space indicated. Your Social Security Number is requested under the authority of Executive Order 9397 to uniquely identify your records from those of other applicants who may have the same name. As allowed by law or Presidential directive, your Social Security Number is used to seek information about you from employers, schools, banks and others who may know you. Providing your Social Security Number is voluntary, however we can not process your application without it.
Vacancy Identification Number (VIN): 754391
Announcement Number: IHS-HQ-12-754391-DH
Enter the lowest grade level that you will accept for this position. The lowest grade for this position is 15.
Select/enter at least one occupational specialty. The specialty code for this position is:
Select/enter at least one geographic location in which you are interested and will accept employment. The location code for this position is:
1. Are you a United States Citizen or National, who is at least 16 years old?A. Yes
The following section is used to determine your eligibility for appointment under the Merit Promotion or Excepted Service Examining Plan in the Indian Health Service. Please respond "Yes" or "No" to the following statements. Do not leave any section blank. NOTE: You must submit the required documentation to verify your eligibility as indicated below. Failure to provide the required documents will render you not eligible for consideration. See instructions under the "How to Apply" tab for submitting documentation.
The following section is used to determine your eligibility for appointment under the Merit Promotion or Excepted Service Examining Plan in the Indian Health Service. Please respond "Yes" or "No" to the following statements. Do not leave any section blank.A- Yes.
2. Are you a current, permanent (non-temporary) civilian employee on a competitive service appointment in a Federal agency or a former civilian Federal employee who achieved career status in the competitive service; or an interchange agreement eligible; or a VEOA eligible; or a former civilian Federal employee who served on a career-conditional appointment and was separated less than three years ago without achieving career status in the competitive service? (You must submit supporting documentation).
3. Are you eligible for Indian preference as defined by the Department of the Interior (DOI) and as evidenced by appropriate Bureau of Indian Affairs (BIA) authorized certification? (You must submit a properly completed and signed copy of the Bureau of Indian Affairs (BIA) Form BIA-4432, "Verification of Indian Preference for Employment in the Bureau of Indian Affairs and the Indian Health Service," for employees claiming Indian preference.)
4. Are you an Indian Health Service scholarship recipient who has completed the necessary requirements for an approved health profession degree in accordance with your academic institution and under the Indian Health Care Improvement Act (IHCIA)? (You will receive highest priority placement consideration for available vacancies within the IHS).
5. Have you held a permanent position in the competitive service at the same grade level with the same or higher promotion potential as this position; or be an Interagency Career Transition Program (ICTAP) applicant; or be eligible for a special appointment authority such as a Schedule A for the severely disabled? (You must submit supporting documentation).
6. Are you interested in performing the duties of this position within the United States Public Health Service Commissioned Corps? (You must submit sufficient information to permit this office to determine whether you meet the qualification requirements, including any selective placement factor).
INSTRUCTIONS: The following section is used to determine your Method of Consideration/Referral.
7. Please indicate which of the following plans you want to be considered under: you will only be considered for those that you indicate and are within reach for referral. Do not leave this section blank.
NOTE: You must also submit the required documentation to verify your eligibility as indicated in the vacancy announcement. Failure to provide the required documents will render you not eligible for consideration.
1. BASIC REQUIREMENT-Degree In order to qualify for this position you must meet the degree requirements for a physician position. Select the response that most closely and accurately describes your background and which demonstrates how you meet the education requirements.A. I have a Doctor of Medicine or Doctor of Osteopathy from a school in the United States or Canada approved by a recognized accrediting body in the year of the applicant's graduation.
From the descriptions below, select the response that best demonstrates your ability to perform the work of this position at the GS-15. Select only one response and do not leave blank.
2. Specialized experience is experience that has equipped the applicant with the particular knowledge, skills, and abilities to perform successfully the duties of the position and is typically in or related to the work of the position to be filled. To be creditable, this experience must have been equivalent to the next lower grade level in the normal line of progression for the occupation. Examples of specialized experience required for this position include: the completion of an approved 3-4 year residency training or equivalent training and experience in one or more of the following specialty areas: Internal Medicine, Family Medicine, Surgery, Pediatrics, and/or Preventive Medicine; experience supervising personnel; experience in developing, managing, and monitoring budgets, contracts, and grants; and skill in leading and/or directing health care programs or organizations to improvements in patient care.A. I have one year of specialized experience equivalent to at least the GS-14 level in the Federal service obtained in either the private or public sector.
3. I have the following number of years of experience utilizing performance management policies and procedures to meet performance goals.A. Less than two
4. I have developed clinical outcome reports using data from clinical information systems.A. On a local or tribal level
5. I have used clinical information systems tools to implement strategies for patient care improvement in one or more of the following areas, patient safety, advanced access, clinical outcomes (e.g., GPRA), and/or cost efficiency.A. Yes
6. I have developed training and curriculum materials and delivered them to diverse audiences.A. Yes
7. I have experience in developing and executing health care budgets.A. Less than one million dollars
8. I have demonstrated skill in leading health care programs or health care organizations in performance improvement projects or activities with the goal of raising the quality of patient care.A. Yes
If yes to question 8, please provide a description of your leadership skills and style in carrying out a performance improvement project.
SECTION II. CERTIFICATION OF INFORMATION ACCURACY
As previously explained, your responses in this Assessment Questionnaire are subject to evaluation and verification. Later steps in the selection process are specifically designed to verify your responses. Deliberate attempts to falsify information will be grounds for disqualifying you or for dismissing you from employment following acceptance. Please take this opportunity to review your responses to ensure their accuracy.
Certification of Information Accuracy
If you fail to answer this question, you will be disqualified from consideration for this position.
9. I certify that, to the best of my knowledge and belief, all of the information included in this questionnaire is true, correct, and provided in good faith. I understand that if I make an intentional false statement, or commit deception or fraud in this application and its supporting materials, or in any document or interview associated with the examination process, I may be fined or imprisoned (18 U.S.C. 1001); my eligibilities may be cancelled, I may be denied an appointment, or I may be removed and debarred from Federal service (5 C.F.R. part 731). I understand that any information I give may be investigated. I understand that responding "No" to this item will result in my not being considered for this position.