Defense Health Agency Program Analyst in Aurora, Colorado
About the Position: The Contract Resource Management (CRM) Division uses Defense
Health Program (DHP) funds provided by annual appropriations from the Congress of the
United States to reimburse private sector health care providers for services rendered to
TRICARE beneficiaries and funding from the Medicare Eligible Retiree Health Care Fund
(MERHCF) for the health care provided through TRICARE for Life (TFL) programs.
Serves as lead responsible for communicating issues under program review; assigning individual or team task
assignments and projects to achieve the objectives of the program.
Prepare reports and maintain records of work accomplishments and administrative information, as required, and coordinate the preparation, presentation and communication of work-related information to the supervisor.
Report to the supervisor periodically on team and individual work accomplishments, problems, progress in mastering tasks and work processes, as well as individual and team training needs.
Serves as the agency?s expert on improper payment identification and IPERIA reporting requirements as it relates to the TRICARE military health benefits program and purchased care contracts.
In collaboration with TCRS COR, develop and/or modify existing TRICARE purchased care contract compliance review requirements to meet IPERA and/or OMB identification and reporting requirements.
Provide technical expertise in the implementation, execution, and operational oversight and/or management of the TCRS contract, compliance review process, and the evaluation of TRICARE private-sector contractor claims processing performance.
Provide technical guidance, expertise and direction in the maintenance and/or modification of the TRICARE Encounter Data Audit application,
and any additional applications/systems utilized in support of the compliance review process and IPEB work efforts.
Conditions of Employment
Who May Apply: Only applicants who meet one of the employment authority categories below are eligible to apply for this job. You will be asked to identify which category or categories you meet, and to provide documents which prove you meet the category or categories you selected.
Current Civilian Employees of the OrganizationPriority Placement Program, DoD Military Spouse Preference (MSP) Eligible In order to qualify, you must meet the experience requirements described below. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document. Specialized Experience: One year of specialized experience which includes: experience working with the improper payment audit process of healthcare claims and current TRICARE purchased care contracts; experience in the surveillance of financial systems for healthcare delivery organizations; experience providing suggested guidance for improving business and management practices to the agency's improper payment identification and reporting systems; and experience planning, coordinating and implementing improper payment audit and reporting requirements in accordance with Improper Payment Elimination and Recovery Improvement Act. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-13).Some federal jobs allow you to substitute your education for the required experience in order to qualify. For this job, you must meet the qualification requirement using experience alone--no substitution of education for experience is permitted. You will be evaluated on the basis of your level of competency in the following areas:
Information ManagementOral CommunicationPlanning and EvaluatingProject Management Time in Grade Requirement: Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-13).
Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation. Male applicants born after December 31, 1959 must complete a Pre-Employment Certification Statement for Selective Service Registration. You will be required to provide proof of U.S. Citizenship. Two year trial/probationary period may be required. Direct Deposit of Pay is required. Selection is subject to restrictions resulting from Department of Defense referral system for displaced employees. You may claim military spouse preference (MSP). If a MSP applicant is determined best qualified and selected, placement must be at the full performance level for priority consideration. Multiple positions may be filled from this announcement. Salary includes applicable locality pay or Local Market Supplement. If you are unable to apply online or need to fax a document you do not have in electronic form, view the following link for information regarding an Alternate Application. Permanent Change of Station (PCS) allowances may be authorized, subject to the provisions of the Joint Travel Regulations and an agency determination that a PCS move is in the Government Interest.