Director, TRICARE Health Plan

Duties
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• 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
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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 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 appointment and annually thereafter.
• You may be required to obtain and maintain an interim and/or final Top Secret security clearance prior to entrance on duty. Failure to obtain and maintain the required level of clearance may result in the withdrawal of a job offer or removal.
• New employees in the Department of War will be required to successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit www.dhs.gov/E-Verify/.
• Within the Department of War (DoW), the appointment of retired military members within 180 days immediately following retirement date to a civilian position is subject to the provisions of 5 United Stated Code 3326.
• This position may require travel from normal duty station to CONUS and OCONUS and may include remote or isolated sites. You must be able to travel on military and commercial aircraft for extended periods of time.
• Supervisors in the executive branch have a heightened personal responsibility for advancing government ethics. You will be required to review the 14 General Principles of Ethical Conduct at 5 CFR 2635.101.

Qualifications

Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution. Candidates will not be hired based on their race, sex, color, religion, or national origin.

To meet the minimum qualification requirements for this position, you must show that you possess the Executive Core Qualifications (ECQ) and Technical Qualifications (TQ) related to this position within your resume. Your Resume must be no more than 2-pages using no less than 10-point font with no less than 1-inch margins all around to describe your qualifications. If you submit a resume that exceeds the two-page limit and/or does not meet the margin or font limitations stated herein, you will immediately be deemed ineligible for this position and will receive no further consideration . Your resume should include examples of experience, education, and accomplishments applicable to the qualification(s). If your resume does not reflect demonstrated evidence of these qualifications, you may not receive consideration for the position. Do NOT submit a separate narrative statement specifically addressing the Executive Core Qualifications (ECQs) or the Technical Qualifications (TQs).

TECHNICAL QUALIFICATIONS (TQs): Your resume should demonstrate accomplishments that would satisfy technical qualifications.

TQ 1. In-depth knowledge of the healthcare industry, with broad experience or understanding of the following: the MHS management; managed health care operations; TRICARE Program operations; and senior leadership experience within civilian or uniformed services healthcare facilities.

TQ 2. Federal acquisition program/project management experience, such as managing a large, multi-faceted healthcare organization, forecasting, developing, managing, and evaluating a program, building/presenting a successful business case, developing a budget, reporting program results, strategic planning, high-level communication with internal/external stakeholders, organizational processes, risk management, quality processes, quality management, schedule, cost control and basic contracting law.

EXECUTIVE CORE QUALIFICATIONS (ECQs): In addition to the Technical Qualification Requirements listed above, all new entrants into the Senior Executive Service (SES) under a career appointment will be assessed for executive competency against the following five mandatory ECQs. If your 2-page resume does not reflect the demonstrated evidence of the ECQs and TQs, you may not receive further consideration for the position. There are five ECQs:

• ECQ 1: Commitment to the Rule of Law and the Principles of the American Founding - This core qualification requires a demonstrated knowledge of the American system of government, commitment to uphold the Constitution and the rule of law, and commitment to serve the American people.
  • Sub-Competencies:
    • Knowledge of the American System of Government: Demonstrates understanding and appreciation of the American system of government, including the Constitution, the Bill of Rights, separation of powers, federalism, and the historical development of the American Nation.
    • Commitment to the Rule of Law: Upholds the principles of the American Founding, including equality under the law and democratic self-government. Ensures the law is applied fairly and consistently.
    • Civic-Mindedness : Stays up-to-date on important developments in American government and aligns organizational objectives and practices with presidential and public interests. Demonstrates a commitment to serve the American people.
• ECQ 2: Driving Efficiency - This core qualification involves the demonstrated ability to strategically and efficiently manage resources, budget effectively, cut wasteful spending, and pursue efficiency through process and technological upgrades.
  • Sub-Competencies:
    • Fiscal Responsibility : Strategically manages, allocates and monitors financial resources. Aligns priorities and initiatives to justify budget proposals. Monitors expenditures, cuts unnecessary costs, and uses cost-benefit analysis to set priorities.
    • Managing Resources : Manages resources efficiently and effectively based on current and projected organizational goals, skills, budget considerations, and staffing needs.
    • Leveraging Technology: Explores emerging technology and potential applications. Incorporates technology to enhance efficiency and achieve results. Ensures access to and security of technology systems.
• ECQ 3: Merit and Competence - This core qualification involves the demonstrated knowledge, ability and technical competence to effectively and reliably produce work that is of exceptional quality.
  • Sub-Competencies:
    • Technical Skill: Possesses the requisite technical knowledge and subject matter expertise to consistently produce timely, high-quality work. Is considered a strong contributor in his or her domain.
    • Problem Solving : Engages in critical and data-driven thinking when diagnosing root causes and evaluating options. Identifies and promptly addresses the most pressing, high-priority problems.
    • Agility and Resilience: Anticipates and adapts to change, new ideas, new information, and new conditions. Is committed to continuous improvement. Deals effectively with pressure and remains optimistic and persistent, even under adversity.
• ECQ 4: Leading People - This core qualification involves the demonstrated ability to lead and inspire a group toward meeting the organization's vision, mission, and goals, and to drive a high-performance, high-accountability culture. This includes, when necessary, the ability to lead people through change and to hold individuals accountable.
  • Sub-Competencies:
    • Accountability: Ensures that employees are appropriately recruited, selected, appraised, trained, and retained. Takes swift action to address performance- or conduct-based deficiencies in employees supervised. Holds self and others accountable for measurable high-quality, timely, and cost-effective results. Developing Others: Recognizes and rewards outstanding achievement in others. Develops the ability of others to perform and contribute to the organization by providing opportunities to learn through formal and informal methods. Cultivates a dynamic environment in which employees are not afraid to make mistakes.
    • Executive Judgement: Makes well-reasoned, timely, and effective decisions and considers short- and long-term implications. Communicates effectively with stakeholders across all organizational levels, sharing and guarding information where appropriate.
• ECQ 5: Achieving Results - This core qualification involves the demonstrated ability to achieve both individual and organizational results, and to align results to stated goals from superiors.
  • Sub-Competencies:
    • Operational Mindset: Effectively translates strategies into actionable steps and processes. Partners effectively with stakeholders to drive adoption and addresses blockers to ensure successful implementation.
    • Innovation: Applies creativity to improving products and processes, challenges convention, takesmeasured risks, and considers ways to simplify and remove unnecessary requirements.
    • Strategic Thinking: Formulates objectives and priorities and implements plans consistent with the long-term interests of the organization by evaluating conditions, resources, capabilities, constraints, and organizational goals and values.

Note : If you are a member of the SES or have been certified through successful participation in an OPM approved SES Candidate Development Program (SESCDP), or have SES reinstatement eligibility, you do not need to respond to the ECQs. Instead, you should attach proof (e.g., SF-50, Certification by OPM's SES Qualifications Review Board (QRB)) of your eligibility for noncompetitive appointment to the SES.

Education

This job does not have an education qualification requirement.

Additional information

• DoW Joint Enterprise-Wide Experience Statement: In addition, DoW 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 DoW or government-wide strategic priorities is required. Executives 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. This information should be embedded within the resume.
• Veterans' Preference is not applicable to the SES.
• This position is not covered by the Department of War referral system for displaced employees.
• Mobility: Organizational and geographical mobility is essential in developing and managing SES leaders. Individuals selected for SES positions members may be subject to reassignment across geographical, organizational, and functional lines, and may be required to sign a Reassignment Rights and Obligation Agreement.
• Tiering: The Department/Agency structures its SES positions into categories (i.e. tiers) to determine the pay range for each position. The categories are based on the position scope, breadth, functions, and placement within the structure of organizational levels across the Department/Agency.
• Recruitment and relocation incentives may be authorized for this position. A relocation is generally a single payment intended to offset some of the relocation costs experienced by the selectee.
• Equal Employment Opportunity (EEO) Policy Statement: http://www.eeoc.gov/federal/index.cfm
• Employment Information Resources - Resource Center: https://help.usajobs.gov/how-to
• When you perform a Civilian Permanent Change of Station (PCS) with the government, the Internal Revenue Service (IRS) considers the majority of your entitlements to be taxable. Visit https://www.dfas.mil/civilianemployees/civrelo/Civilian-Moving-Expenses-Tax-Deduction/ for more information.
• If you have retired from federal service and you are interested in employment as a reemployed annuitant, see the information in the Reemployed Annuitant information sheet.
• 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.

There are three key documents that contain important information about your rights and obligations. Please read and retain these documents:

• Noncriminal Justice Applicant's Privacy Rights , for those who undergo an FBI fingerprint-based criminal history record check for personnel vetting, which includes Rap Back,
• FD-258 Privacy Act Statement - FBI (this is the same statement used when your fingerprints are submitted as part of your background investigation), and
• SEAD-3-Reporting-U.pdf (dni.gov) , (applicable to those who hold a sensitive position or have eligibility for access to classified information)
• OPM must authorize any employment offers made to current or former (within the last 5 years) political Schedule A, Schedule C, or Non-career SES employees in the executive branch. If you are currently, or have been within the last 5 years, a political Schedule A, Schedule C, or Noncareer SES employee in the executive branch, you must disclose that to the Human Resources Office.