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USAJOBS · 1 week ago

Director, TRICARE Health Plan

Falls Church, Virginia, USA

Full-time

Onsite

Director/Executive

$184K/yr - $226K/yr

USAJOBS is seeking a Director for the TRICARE Health Plan within the Defense Health Agency. This role involves providing senior executive leadership on programmatic and operational matters related to TRICARE, overseeing policy development, and managing a significant budget to ensure efficient healthcare delivery.

ConsultingGovernmentHuman ResourcesInformation TechnologyInternetStaffing Agency

No H1B

Security Clearance Required

U.S. Citizen Only

Responsibilities

Provide senior executive leadership on organizational, programmatic, operational and policy matters pertaining to the worldwide management of TRICARE managed care as well as purchased care programs

Coordinate/integrate activities of subordinate organizations to ensure achievement of DHA mission. Interface with Service Deputy Surgeons General/Agency executive leadership to facilitate achievement of Military Health System (MHS) Strategic Plan

Set the strategy for TRICARE Health Plan to support seamless integration between the direct care system and private sector care partners

Oversee contract cost management, ensuring ongoing purchased care operations of MHS are working smoothly and efficiently

Ensure that future needs are properly planned for, including policy for the introduction of new business practices, technologies, and approaches to existing and future programs

Direct/oversee the development/execution of TRICARE policies, healthcare benefits and reimbursement systems, TRICARE and other healthcare program requirements, beneficiary and provider services, and health plan acquisition support

Participate in development, formulation, implementation, and advocacy of health care operational policies, MHS transformation, DHA strategic plan/initiatives, and program objectives of critical importance to the goals of the Secretary of War

Plan, program, and manage the approximately $20 billion annual budget for private sector care within the TRICARE program

Ensure TRICARE program compliance and adequacy in areas of policy interpretation/ administration and clearly defined lines of authority, responsibility/accountability are established for all assigned programs

Develop plans and policies and ensures review and maintenance of program milestones

Ensure the TRICARE program complies with information confidentiality and security requirements and reviews any potential breach. Provide oversight of investigations and responds to congressional and other high-level inquiries

Oversee Managed Care Support Contractor compliance regarding Health Insurance Portability and Accountability Act, patient safety and risk management, professional credentialing, and patient relations/customer service

Maintain accountability and standardize all medical protocols, policies, procedures and practices related to the TRICARE program

Oversee Quality Assurance program to ensure standardized and high-quality care. Develop and maintain an evaluation process for local and regional health plan performance and provide active feedback in support of necessary improvements

Provide senior-level direction for determining and defining long-range operating and management goals and objectives for program operations. Review and continuously evaluate results achieved by the TRICARE Program

Ensure proper and adequate program accomplishment and provide recommendations for improving program implementation

Facilitate resolution of programmatic and operational issues raised by the TRICARE Area Offices along with coordinating the management of all overseas healthcare delivery

Provide senior executive direction to address and resolve issues and requirements resulting from new or modified legislation and/or regulation that may impact the delivery of health care

Chair or participate in various committees with representation by senior management officials from Federal, State, or private sector organizations on DoW healthcare care policies

Provide executive direction to subordinate organizations, determining/defining long-range operating and management goals/objectives for program operations. Review/continuously evaluate results achieved by the TRICARE program

Qualification

Healthcare industry knowledgeManaged care operationsFederal acquisition managementStrategic planningBudget managementRisk managementQuality managementHigh-level communicationAgilityResilienceLeadershipProblem solving

Required

Must be a U.S. Citizen. You will be required to provide proof of U.S. Citizenship

Male applicants born after December 31, 1959 must complete a Pre-Employment Certification Statement for Selective Service Registration

Must participate in the direct deposit pay program

You will serve a one-year probationary period unless you have previously completed the probationary period in the SES

You will be required to complete a Declaration for Federal Employment to determine your suitability for Federal employment, at the time requested by the agency

You must submit to a drug test and receive a negative drug test before you can be appointed into this position. Designated and/or Random Drug Testing required

You will be required to complete ethics orientation within three months of appointment, and submit a Public Financial Disclosure Report, OGE-278e within 30 days of appointment and annually thereafter

You may be required to obtain and maintain an interim and/or final Top Secret security clearance prior to entrance on duty. Failure to obtain and maintain the required level of clearance may result in the withdrawal of a job offer or removal

New employees in the Department of War will be required to successfully pass the E-Verify employment verification check

This position may require travel from normal duty station to CONUS and OCONUS and may include remote or isolated sites. You must be able to travel on military and commercial aircraft for extended periods of time

Supervisors in the executive branch have a heightened personal responsibility for advancing government ethics. You will be required to review the 14 General Principles of Ethical Conduct at 5 CFR 2635.101

To meet the minimum qualification requirements for this position, you must show that you possess the Executive Core Qualifications (ECQ) and Technical Qualifications (TQ) related to this position within your resume

Your Resume must be no more than 2-pages using no less than 10-point font with no less than 1-inch margins all around to describe your qualifications

If you submit a resume that exceeds the two-page limit and/or does not meet the margin or font limitations stated herein, you will immediately be deemed ineligible for this position and will receive no further consideration

Your resume should include examples of experience, education, and accomplishments applicable to the qualification(s). If your resume does not reflect demonstrated evidence of these qualifications, you may not receive consideration for the position

Your resume should demonstrate accomplishments that would satisfy technical qualifications

Preferred

In-depth knowledge of the healthcare industry, with broad experience or understanding of the following: the MHS management; managed health care operations; TRICARE Program operations; and senior leadership experience within civilian or uniformed services healthcare facilities

Federal acquisition program/project management experience, such as managing a large, multi-faceted healthcare organization, forecasting, developing, managing, and evaluating a program, building/presenting a successful business case, developing a budget, reporting program results, strategic planning, high-level communication with internal/external stakeholders, organizational processes, risk management, quality processes, quality management, schedule, cost control and basic contracting law