This position is located within the Department of Homeland Security (DHS), Immigration and Customs Enforcement (ICE), Enforcement and Removal Operations (ERO), ICE Health Service Corps (IHSC), Office of Deputy Assistant Director for Healthcare Compliance, Office of Health Plan Management Unit (HPMU). The incumbent reports directly to the IHSC Claims Management Program Administrator (CMPA). This is a supervisory position.
HPMU focuses on medical claims program through the governance of a provider network, claims adjudication and utilization management. HPMU collaborates with the Veterans Affairs Financial Services Center (VAFSC), a third-party medical claims administrator, and offsite providers to establish letters of understanding with IHSC. HPMU also works jointly with IHSC stakeholders: pharmacy; dental; the Behavioral Health Unit; the Medical Case Management Unit; and IHSC headquarters to meet mission initiatives. HPMU trains field medical coordinators, managed care coordinators and referral coordinators to improve processes related to the recruitment and retention of outside providers and claims process workflows to decrease claims denials and increase the number of paid claims.
In Fiscal Year (FY) 2024, IHSC provided direct care to more than 138,000 noncitizens housed in 18 facilities throughout the nation to include medical, dental, and mental health care, and public health services. In FY 2024, IHSC oversaw compliance with health-related standards for over 186,900 detained noncitizens housed in 129 non-IHSC-staffed facilities, totaling almost 45,500 beds.
SUPERVISORY CONTROLS
The CM Program Analyst Lead works under the supervision of the IHSC HPMU Claims Management Program Administrator. The incumbent plans and organizes his/her own work, determines the sequence of assignments, selects and develops methods, and seeks assistance from experts only rarely. Assignments are usually long-term, recurring, or broadly defined. Work is reviewed for feasibility, compatibility with other work, and effectiveness in meeting requirements or expected results.