Job Listing
Program Manager
Veterans Health Administration · Posted 7 days ago
About the Role
The Director of QSV Quality and Performance provides financial and other program support to the Under Secretary for Health on a wide range of health benefit administration matters. The incumbent is a critical member of the Integrated Veteran Care, Integrated External Networks senior management team. He/She is directly responsible for the QSV Quality & Performance, Community Care Program. With responsibilities encompassing VHA health care delivery nationwide.
What You'll Do
- →Area of Consideration- Eligible applications will be reviewed and referred in the following order: 1.
- →Current VA employees designated as surplus or displaced by the VA - Career Transition Assistance Plan (CTAP) eligible 2.
- →Current IVC employees located at Denver Federal Center, West 6th Avenue & Kipling Street, Lakewood, CO, 80225 3.
- →Current IVC employees located at 810 Vermont Ave NW, Washington, DC 20420 4.
- →Current IVC employees selecting location negotiable Duties: Direct enterprise-wide healthcare payment/medical claim integrity, medical claim invoice reimbursement oversight, claims adjudication, enrollment, and eligibility operations supporting Veterans, beneficiaries, providers, and healthcare facilities.
- →Provide executive leadership and strategic direction for IVC IEN Payment and Business Integrity operations, governance, modernization, and organizational transformation initiatives.
- →Oversee development and implementation of enterprise governance frameworks, internal controls, compliance oversight, and operational accountability processes related to healthcare payment operations.
- →Lead enterprise payment integrity strategies focused on improper payment reduction, operational risk mitigation, claims accuracy, and financial stewardship.
- →Direct post-payment review operations, escalation pathways, analytics initiatives, corrective action activities, and continuous process improvement efforts.
- →Oversee implementation of automation, advanced analytics, operational reporting, and monitoring capabilities supporting healthcare business operations and payment oversight activities.
- →Collaborate with executive stakeholders, clinical leadership, oversight bodies, contractors, and program offices to resolve operational, policy, compliance, and healthcare business issues.
- →Provide executive-level advisement and strategic recommendations to senior leadership regarding healthcare payment operations, organizational performance, operational effectiveness, and enterprise business strategy.
- →Lead organizational alignment, workforce planning, governance development, and operational readiness activities supporting evolving healthcare business priorities.
- →Direct enterprise data-driven analytics initiatives supporting healthcare payment oversight, operational efficiency, risk reduction, and organizational decision-making.
Requirements
- ✓You must be a U.S.
- ✓Citizen to apply for this job To be considered for this position, you must complete all required steps in the process.
- ✓In addition to the application and questionnaire, this position requires an online assessment.
- ✓The online assessment measures critical general competencies required to perform the job.
- ✓Selective Service Registration is required for males born after 12/31/1959 Physical Requirements: The work required does not inherently include any physical requirements essential for successful job performance that could not otherwise be performed with accommodation or workplace adjustment.
- ✓A pre-placement physical examination is not required.
- ✓Subject to background/security investigation Selected applicants will be required to complete an online onboarding process.
- ✓Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents).
- ✓Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
- ✓Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period or 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest.
- ✓In determining if your employment advances the public interest, we may consider: your performance and conduct; the needs and interests of the agency; whether your continued employment would advance organizational goals of the agency or the Government; and whether your continued employment would advance the efficiency of the Federal service.
- ✓Upon completion of your probationary period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.
- ✓There is no educational substitution at this grade level.
Personality Fit
Job ID: 6c122249-2b7a-47be-9603-ecf17a421b98
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