Director, TRICARE Health Plan

About the Position:

You will serve as the Director, TRICARE Health Plan located in the Defense Health Agency (DHA) in the Office of the Assistant Secretary of War for Health Affairs (OASW(HA)), Office of the Under Secretary of War for Personnel and Readiness (OUSW(PR)).

This is not a virtual/remote position. You must live within or be willing to relocate within a commutable distance of the identified duty location (Falls Church, Virginia).

• 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.

• 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…