Director, TRICARE Health Plan
Full-time
Director/C-Level
3 days ago
Provide senior executive leadership on organizational, programmatic,.....
- 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.
Starting at $180,359 Per Year (ES 00)
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