Director, TRICARE Health Plan Security Clearance

Position: Director, TRICARE Health Plan with Security Clearance
Duties Help
* 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. Requirements Help Conditions of employment
* 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…