Work in Washington Veterans Jobs

Job Summary Serves as TriWest's primary representative to the Military and Veterans' Services Administration (VA) healthcare facilities within a specified geographic area relating to TriWest contracted services for the VA Community Care Network (CCN) and the Department of Defense (DoD) TRICARE West Region managed care support contract. The incumbent will perform account management services and be responsible for building collaborative relationships with, resolving issues for, and identifying optimization opportunities to improve the experience of the supported healthcare facilities and respective staffs, network providers, and VA and DoD healthcare beneficiaries within their assigned service area of responsibility. The incumbent serves as the primary point-of-contact (POC) for bringing the collective TriWest corporate functions together in support of the facilities, contracted provider network, and beneficiary community support needs. The position reports to the assigned Vice President in the Military and Veteran's Services organization. Education & Experience Required: Bachelor's degree in Health Care Administration, Business, or related field 7 years of middle to senior management experience, with increasing responsibility 3+ years of recent healthcare experience Strong customer service orientation Preferred: Master's degree in Health Care Administration, Business, or related field Knowledge of the business relationships between health plans and network providers, health plan beneficiaries/members, and managing contract performance matters Prior experience and management-level work in VA healthcare, MTFs, and TRICARE Managed Care experience and working with contract performance requirements Key Responsibilities Develops and maintains a clear understanding of TriWest's contracted responsibilities and performance requirements of the VA's Community Care Network and the DoD's TRICARE West Region managed care support contract. Maintains ongoing communications and functions as the primary TriWest POC for the assigned medical facility leadership and their staffs regarding services and support provided by TriWest departments. Meets with medical facility leadership on a monthly basis to gauge ongoing support, adjust to capabilities and capacity changes, prepare for contingencies, identify issues and challenges, and assess other ongoing needs. Educates medical facility staff regarding TriWest processes and systems and provides direct support and assistance to them regarding business plan development and updates. Develops proposals for improved healthcare delivery and care coordination between the medical facilities healthcare system, and community healthcare. Supports the integration of referral management, medical management, provider services, and claims with the provider network. Develops, monitors compliance, initiates changes as needed, and annually reviews the Memorandum of Understanding (MOU) and Statement of Responsibility, if required, with each DoD medical facility in their assigned regional area of responsibility. Oversees beneficiary education activities and supervises and supports the Beneficiary Education and Services Representative(s) within their assigned regional area of responsibility. Plans and facilitates TriWest participation and response to MTF contingency exercises. Prepares reports as needed to provide description, assessment, and lessons learned per contract requirements. Maintains liaison with State Adjutants General, National Guard and Reserve Commanders and their organizational and medical staff within the assigned regional area of responsibility as well as the National Oceanic Atmospheric Administration (NOAA) Public Health Service regarding the provision of TRICARE education and services support. <