Job summary

About the Position: You will serve as the Director, TRICARE Health Plan (THP) located in the Defense Health Agency (DHA) in the Office of the Assistant Secretary of Defense for Health Affairs (OASD(HA)), Office of the Under Secretary of Defense for Personnel and Readiness (OUSD(P&R)). This position reports directly to the Assistant Director, Healthcare Administration.

Major duties

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. Interfaces 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 Defense. 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 standardizes 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 provides 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 DoD 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

Who May Apply: US Citizens ***THIS POSITION IS PART OF THE DEPARTMENT OF DEFENSE QUALIFICATIONS REVIEW BOARD PILOT PROGRAM. ***Please read this announcement in its entirety before applying. ***Current SES retain their status in the SES if appointed. Under the DoD Pilot Program, there is no requirement to prepare a narrative statement specifically addressing the Executive Core Qualifications (ECQs). However, to meet the minimum qualification requirements for this position, you must show that you possess the five Executive Core Qualifications within your resume - not to exceed five pages. Your application must also include a narrative statement specifically addressing the mandatory technical qualifications (MTQ), not to exceed a total of two pages. https://www.opm.gov/ses/references/guidetoSESQuals_2012.pdf Each accomplishment should be clear, concise, and emphasize your level of responsibilities; the scope and complexity of the programs, activities, or services you managed; program accomplishments; policy initiatives undertaken; level of contacts; the sensitivity and criticality of the issues you addressed; and the results of your actions. You should use action-oriented leadership words to describe your experience and accomplishments (e.g., led the development and implementation of….) and quantify your experience wherever possible to demonstrate your accomplishments (e.g., number of employees supervised; size of budget managed; amount of money saved, etc.). ECQ 1 - Leading Change: This core qualification involves the ability to bring about strategic change, both within and outside the organization, to meet organizational goals. Inherent to this ECQ is the ability to establish an organizational vision and to implement it in a continuously changing environment. ECQ 2 - Leading People: This core qualification involves the ability to lead people toward meeting the organization's vision, mission, and goals. Inherent to this ECQ is the ability to provide an inclusive workplace that fosters the development of others, facilitates cooperation and teamwork, and supports constructive resolution of conflicts. ECQ 3 - Results Driven: This core qualification involves the ability to meet organizational goals and customer expectations. Inherent to this ECQ is the ability to make decisions that produce high-quality results by applying technical knowledge, analyzing problems, and calculating risks. ECQ 4 - Business Acumen: This core qualification involves the ability to manage human, financial, and information resources strategically. ECQ 5 - Building Coalitions: This core qualification involves the ability to build coalitions internally and with other Federal agencies, State and local governments, nonprofit and private sector organizations, foreign governments, or international organizations to achieve common goals. MANDATORY TECHNICAL QUALIFICATIONS: All applicants must submit written statements (narrative format) of accomplishments that address the technical qualifications. You are required to respond to all of the technical qualifications. If you fail to do so, you will be rated as ineligible. Please limit your written statement addressing the mandatory technical qualifications to no more than a total of two pages. In-depth knowledge of the healthcare industry, with broad experience and understanding of the following: the MHS management; managed health care operations; TRICARE Program operations; and senior leadership experience within civilian and uniformed services healthcare facilities. Extensive in-depth knowledge of federal, legislative, and regulatory policies and procedures, at the senior level, that govern the business imperatives, human resources, contracting and logistical systems and processes relative to strategically planning for, developing, acquiring, deploying, and maintaining a broad array of administrative and management programs. Federal acquisition program and project management experience, such as managing a large, multi-facets healthcare organization, developing, and managing a program budget, building and presenting a successful business case, reporting program results, strategic planning, high-level communication with internal and external stakeholders, organizational processes, risk management, quality processes and quality management, schedule, cost control and basic contracting law. Experience and knowledge should include evaluation of program accomplishments and/or projected changes for impact on civilian and military healthcare programs or resources. Demonstrated ability to develop and implement organizational vision that integrates key program goals, priorities, values, and other factors. Inherent to this is the ability to balance change and continuity to continually strive to improve customer service and program performance within the basic government framework; to create a work environment that encourages creative thinking; and the ability to maintain focus, intensity, and persistence, even under adversity. DoD Joint Enterprise-Wide Experience Statement: In addition, DoD requires an Enterprise Perspective. This individual must have the ability to apply a broad point of view and an awareness and understanding of individual or organizational responsibilities in relation to DoD or government-wide strategic priorities is required. Candidates must demonstrate ability to work with internal and external partners to support national security objectives. This perspective is typically gained through a variety of diverse work experiences. A separate narrative statement is not required. This information should be embedded within the application package (resume and technical qualifications narrative statement). Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g. professional, philanthropic, religious, spiritual, community, student, and social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment.

Evaluations

You will be evaluated on the quality and extent of your accomplishments, experience, and education. Your application will be evaluated by a rating and ranking panel. Highly qualified candidates may undergo an interview and a reference check. The Office of the Secretary of Defense Executive Resources Board will review results and make recommendations on final selections to the appointing authority.