Program Analyst

Job Title

Program Analyst

Help

• Prioritizes escalated provider issues related to unpaid claims for services provided and coordinates with Agency regional healthcare networks (i.e., Veterans Integrated Service Networks) and medical centers and contractors to resolve them.
• Monitors appeals from providers within assigned geographic areas and provides support to the local Agency medical centers or third-party administrator as needed to ensure providers' issues are addressed.
• Communicates issues to stakeholders and helps create action plans to improve quality metrics and maintains contact with stakeholders throughout the appeal process.
• Communicates and negotiates with internal and external stakeholders to accept and implement recommendations involving resources, required changes in established procedures, and impacts to the stakeholder; independently produces reports and documents per management's request
• Conducts data analyses, data validations, and program analyses to assess the efficiency and effectiveness of processes in place at field facility associated with the Program Office's operations
• Analyzes trends for a range of initiatives (e.g., network adequacy, provider complaints, credentialing compliance) compared across Program Office geographic regions on a national level, identifying areas where deficiencies or irregularities that may need further review, research, and/or analysis to determine anomalies between sites
• Quantitatively and qualitatively analyzes and evaluates the effectiveness of wider employing office operations in meeting established goals and objectives.
• Drafts responses to external inquiries and develops issue briefs, routing to appropriate management/staff as required.
• Makes formal and informal presentations outlining the history, current status, and objectives of analyses and quality improvement functional responsibilities.
• Develops training content and associated presentation material to educate/inform Program Office partners (e.g., contractors, Agency field staff) on Program Office operations, policies, and processes related to provider network management administration.
• Administers and integrates the work of assigned project team members from different organizations for assigned projects to include scheduling, tracking progress, providing project and task status updates to project team members and management, and adhering to due dates and other requirements.
• Develops strategies that include considerations of current program operations, associated systems, and future initiatives
• Other duties as assigned.

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:

Mon
- Fri, 8 hours a day based on business needs

Telework:
Telework eligibility will be discussed during the interview process.

Virtual:
This position may be authorized for Virtual Work. Virtual Work eligibility is for current VA employees that are already subject to the return to the in-person work mandate in their current position. Definition of Virtual Work:
Employee works outside of original hiring duty station at a VA-owned or leased space. Return to Office (RTO): RTO mandates are in effect and selectees will be required to report to in-person work unless they are approved for an exception or an exemption. Any approval for an RTO exception, exemption, or extension will happen after a tentative job offer, but before a final job offer.

Position Description/PD#:
Program Analyst PD05098A and PD56770A

Relocation/Recruitment

Incentives:

Not authorized.

Critical Skills Incentive (CSI):
Not approved.

Permanent Change of Station (PCS):
Not authorized.