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): 754414
Announcement Number: IHS-12-HQ-754414-ESEP/MP
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.
Thank you for your interest in this Dental Officer position with the Indian Health Service. We will evaluate your resume and your responses to this Assessment Questionnaire to determine if you are among the best qualified for this position. Your responses are subject to verification. Please review your responses for accuracy.
SECTION 1. MINIMUM QUALIFICATIONS AND FACTORS.
1. From the description below, select the response that best describes your education and meets the Basic Qualification Requirement for Dental Officer, GS-0680-15.A. I have a Degree in dental surgery (D.D.S.) or dental medicine (D.M.D.) from a school approved by the Council on Dental Education, American Dental Association (ADA); or other dental school, provided the education and knowledge acquired was substantially equivalent to that of graduates from an ADA-approved school.
2. Are you currently licensed to practice dentistry in a State, the District of Columbia, or Puerto Rico?A. Yes
3. Are you able to distinguish all shades of color?A. Yes
4. From the description below, select on which best describes your experience and/or training and meets the Additional Qualification Requirement for Dental Officer GS-680-15.A. I have Post-licensure professional experience in the general practice of dentistry.
From the descriptions below, select the response that best describes your experience which demonstrates your ability to perform the work of this position at the GS-15.
5. Specialized Experience Requirement: Examples include; mastery of the theoretical and applied principles and concepts of clinical dentistry; experience in utilizing dental clinical information systems; experience in leading personnel towards successful performance outcomes; experience in developing, managing, and monitoring budgets, contracts, and grants for dental programs; and experience in leading or directing dental programs or organizations to improvements in dental care, dentist recruitment projects, and/or patient safety.A. I have one year of professional dentistry experience equivalent to at least the GS-14 level.
6. I have four or more years of dental practice experience.A. Yes
7. I have the following number of years of experience utilizing performance management techniques and principles to meet performance goals.A. Less than two
8. I have developed dental outcome reports using data from clinical dental information systems.A. On a local or tribal level
9. I have used dental outcomes data to implement strategies for dental practice improvements in one or more of the following areas, patient safety, advanced access, clinical outcomes (e.g., GPRA), and/or cost efficiency.A. Yes
If yes to question 9, please describe an example of a strategy you implemented including the results and whether the strategy served as a model for others (replicated outside your immediate work unit).
10. I have developed oral health training and curriculum materials.A. Yes
11. I have experience in developing and executing dental or health care budgets.A. Less than one million dollars
12. I have used my knowledge of budgeting methods, project management, contracts or grants to achieve cost-savings while maintaining patient care quality.A. Yes
13. I have led diverse dental teams or organizations to meet national oral health goals, such as evaluation of national oral health initiatives.A. Yes
If yes to question 13, please describe an example of how you lead teams to meet a national goal.
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.
14. 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.