Director, TRICARE Health Plan Job in Falls Church, VA

Vacancy No. HQKF245251218906SES Department Defense Health Agency
Salary $180,359.00 to $221,900.00 Grade 00 to 00
Perm/Temp Permanent FT/PT Full-time
Open Date 11/18/2024 Close Date 12/17/2024
Job Link Apply Online Who may apply Public
Locations:
Falls Church, VA


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.

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.

Requirements

Conditions of Employment

  • You must be a U.S. Citizen to qualify for this position.
  • You must be determined suitable for Federal employment.
  • You must participate in the direct deposit pay program.
  • Males born after 12-31-59 must be registered or exempt from Selective Service (see https://www.sss.gov/Home/Registration).
  • All newly appointed Career SES must sign the Reassignment Rights Obligations Agreement as a condition of appointment into the SES.
  • 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 will be required.
  • In order to qualify for this position, you must be able to obtain a 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.
  • You will be required to complete ethics orientation within three months of appointment and submit a Public Financial Disclosure Report, OGE-278 in accordance with the Ethics in Government Act of 1978 within 30 days of appointment.
  • You will serve a one-year probationary period unless you have previously completed the probationary period in the SES.
  • You 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/.
  • See Additional Information Section for additional conditions of employment

Qualifications

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.
  1. 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.
  2. 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.
  3. 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.
  4. 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.

Education

This job does not have an education qualification requirement.

Additional information

  • This position is in the Senior Executive Service (SES), a small elite group of top government leaders. SES members possess a diverse portfolio of experiences including strong skills to lead across organizations. As an executive, you will influence the direction of innovation and transformation of the federal government and lead the next generation of public servants.
  • Appointment may be subject to a suitability or fitness determination by a completed background investigation.
  • You will be required to provide proof of U.S. Citizenship.
  • This position is not covered by the Department of Defense referral system for displaced employees.
  • Veterans' preference is not applicable to the Senior Executive Service.
  • Applications MUST be submitted through USA Jobs.
  • Within the Department of Defense (DoD), the appointment of retired military members within 180 days immediately following retirement date to a civilian position is subject to the provisions in 5 United States 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.
  • 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.
  • A recruitment incentive MAY be authorized to eligible new hires.
  • A relocation incentive is generally a single payment intended to offset some of the relocation costs experience by the selectee. A relocation incentive MAY be authorized.

How You Will Be Evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

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.

Required Documents

If you fail to provide these documents, you will be marked as having an incomplete application package and you will not be considered any further.

1. Your resume: Your resume must address your qualifications for the position and cannot exceed five pages. You do not need to submit a separate statement specifically addressing the Executive Core Qualifications (ECQs), but you must show how you possess the five ECQs within the resume narrative. In addition, applicants typically provide the following information:

  • Vacancy Announcement number HQKF245251218906SES.
  • Full name, email and mailing address, and day and evening telephone numbers.
  • Educational information including the name, city, and state of colleges or universities you attended, as well as the type of any degree received. Report only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education. For more information, you may refer to the following U.S. Department of Education website: https://www.edu.gov/admins/finaid/accred/index.html.
  • Information about your paid and nonpaid work experience related to this position including: job title, duties and accomplishments, employer's name and address, duration of employment, and salary.
  • Information about honors, awards, and special accomplishments.
2. Mandatory Technical Qualifications (MTQs): A narrative statement specifically addressing the mandatory technical qualifications should not exceed a total of two pages.

3. Copy of the Notification of Personnel Action (SF 50):
Current and former career SES members must provide an SF-50 showing their status or reinstatement eligibility. Candidates who have successfully completed an Office of Personnel Management approved SES Candidate Development Program must submit a copy of their ECQ certification.

4. Are you claiming membership in any professional organizations, or possession of a license, certificate or credentials? Check the Conditions of Employment section above to see if any are required. If you claim membership, license, certification, or credentials, you must submit a copy of said document in your application package.

5. Is there a basic education requirement for this position? Are you using education as a substitute for some or all of the experience requirement? Check the Education section above to see what is allowed and what is required. Any claims you make in your resume or assessment questionnaire regarding education or degrees must be supported by unofficial transcripts or a list of courses, grades earned, completion dates, and quarter and semester hours earned issued from your school. You may submit a copy of your degree(s) if specific coursework does not have to be verified. Claims for approved "grandfather" clauses must be fully supported with documentation.

DO NOT SUBMIT ANY ADDITIONAL INFORMATION: Extraneous materials such as award certificates will not be considered.

NOTE: Documents submitted as part of the application package, to include supplemental documents, may be shared beyond the Human Resources Office. Some supplemental documents such as military orders and marriage certificates may contain personal information for someone other than you. You may sanitize these documents to remove another person's personal information before you submit your application. You may be asked to provide an un-sanitized version of the documents if you are selected to confirm your eligibility.

How to Apply

TO SUBMIT AN APPLICATION THROUGH USAJOBS: In order to expedite the review of your application, you must submit a complete online application package to include the Resume and narrative statement addressing the Mandatory Technical Qualifications.

The complete application package must be submitted by 11:59 PM (EST) on 12/17/2024 to receive consideration.

  • To begin, click Apply to access the online application. You will need to be logged into your USAJOBS account to apply. If you do not have a USAJOBS account, you will need to create one before beginning the application (https://apply.usastaffing.gov/ViewQuestionnaire/12608906).
  • Follow the prompts to select your resume and/or other supporting documents to be included with your application package. You will have the opportunity to upload additional documents to include in your application before it is submitted. Your uploaded documents may take several hours to clear the virus scan process.
  • After acknowledging you have reviewed your application package, complete the Include Personal Information section as you deem appropriate and click to continue with the application process.
  • You will be taken to the online application which you must complete in order to apply for the position. Complete the online application, verify the required documentation is included with your application package, and submit the application. You must re-select your resume and/or other documents from your USAJOBS account or your application will be incomplete.
  • It is your responsibility to verify that your application package (resume, supporting documents, and responses to the questionnaire) is complete, accurate, and submitted by the closing date. Uploaded documents may take up to one hour to clear the virus scan.
  • Additional information on how to complete the online application process and submit your online application may be found on the USA Staffing Applicant Resource Center.

To verify the status of your application, log into your USAJOBS account (https://my.usajobs.gov/Account/Login), all of your applications will appear on the Welcome screen. The Application Status will appear along with the date your application was last updated. For information on what each Application Status means, visit: https://www.usajobs.gov/Help/how-to/application/status/

Do not email or send hard copy resumes/applications to the Contact Information or Agency Information listed in this vacancy announcement. All resumes/applications received at the addresses listed in the Contact Information or Agency Information will be destroyed and will not be considered for this vacancy announcement.

Agency contact information

Army Applicant Help Desk
Address
KF-DHA-DDAAFC DEFENSE HEALTH AGENCY HQ
DO NOT MAIL
Falls Church, VA 22042
US
Learn more about this agency

Next steps

If you provided an email address, you will receive an email message acknowledging receipt of your application. Your application package will be used to determine your eligibility, qualifications, and quality ranking for this position. If you are determined to be ineligible or not qualified, your application will receive no further consideration.


Note: We cannot accept applications on behalf of Federal Agencies. Application instructions are listed within the Job Description.