Job Description:

Job Summary

Serves as TriWest's senior representative and leader for a group of Regional Directors who act as the primary account managers for the Department of Defense's (DoD) and Veterans Affairs' (VA) healthcare facilities in support of the VA Community Care Network (CCN) and the DoD TRICARE West Region managed care support contracts (MCSC). The incumbent leads their team in developing and maintaining positive, collaborative relationships with the supported health facilities' leadership and respective staffs, network providers, and healthcare beneficiaries within their assigned geographic area of responsibility. The incumbent will oversee ongoing monitoring, communication, and coordination of support for the healthcare facilities and accomplishment of TriWest's contract operational goals and performance requirements. The incumbent reports to the Deputy Chief, Military and Veteran Services Officer. Primary responsibilities include: support and drive operational plans and execution to positively impact healthcare costs, clinical outcomes, access to healthcare, military medical readiness, performance improvement, and beneficiary satisfaction.

Education & Experience

Required:

• Master's degree in Health Care Administration or equivalent
• 5+ years of executive level management and leadership experience in the health care field
• Experience in planning and executing complex operations
• Knowledge of contingency and mobilization planning
• Experience in direct healthcare delivery and quality improvement essential
• Executive-level experience with the military health services system and the TRICARE program

Preferred:

• Senior consulting, CEO or COO experience in healthcare field
• Experience with development and management of integrated health care delivery systems
• Experience in developing clinical and operational health care policy at a corporate level
• Experience with managed care programs
• Hospital administration experience
• Experience and/or demonstrated knowledge of VA healthcare operations, including its Community Care Network
• Experience in "start-up" operations
• Experience in population health and optimization of health care delivery
• Experience with national quality initiatives

Key Responsibilities

• Develops and maintains a clear understanding and functional level of expertise regarding TriWest's contracted responsibilities and performance requirements relating to the VA's Community Care Network and the DoD's TRICARE West Region managed care support contracts.
• Develops and maintains strategic relationships with the leadership of DoD and VA Healthcare facilities' within the assigned geographic area of responsibility, applying comprehensive knowledge of the VA health system processes and the DoD's Defense Health Agency (DHA), Knowledge, Skills and Abilities (KSAs), MCSC performance standards, cost drivers and healthcare delivery operations in both the direct care system and contracted network of providers.
• Collaborates with TriWest functional areas and the assigned health facility leadership to optimize healthcare delivery quality and efficiency, including assessment of healthcare demand and provider network capacity.
• Oversees proposal development for resolving inefficient work processes.
• Supervises and leads the TRICARE Readiness, Integration, and Delivery (TRIAD) team in working with DoD healthcare facility leadership and the TRICARE beneficiary communities within the assigned geographic area of responsibility.
• Coordinates closely with TriWest's senior executive operational and clinical leadership regarding the clinical decision support activities provided to healthcare facilities.
• Leads Regional Directors and supports staff in monitoring, evaluating, and advising TriWest leadership regarding TriWest's performance of customer service, contract requirements and the quality and effectiveness of integrated operations between the supported direct care system and provider network.
• Researches national, DoD, and Department of VA quality initiatives at the health plan level and identifies potential impact on supported healthcare facilities' operations.
• Leads TRIAD team in consulting activities and proposals to MTFs aimed at positively impacting program and process improvement, stakeholder satisfaction, optimization of the MTF, and improved integration of the direct care and purchased care environments.
• Oversees Regional Directors in monitoring compliance, initiating changes as needed, and annually reviewing the Memoranda of Understanding (MOU) and Statements of Responsibility, if required, with each DoD medical facility in their regional area of responsibility.
• Oversees and leads assigned Directors and staff in their liaison and support activities on behalf of the State Adjutants General, National Guard and Reserve organizations, Special Operations commands, as well as the National Oceanic and Atmospheric Administration (NOAA) and Public Health Service members regarding the provision of TRICARE education and services within the assigned geographic area.
• Directs staff augmentation contracting process, including Clinical Support Agreements (CSA) and Internal Resource Sharing Agreements (RSA) in coordination with the subcontracted staffing vendor.
• Oversees activities relating to development of MTF External Resource Sharing Agreement (ERSA) contracting process, facilitating MTF providers' access to network facilities where they are better able to maintain/increase their readiness skills (KSAs) in coordination with other TriWest departmental leadership.
• Consults with the Chief Medical Officer and Medical Directors regarding quality reports, focused quality reviews, and interventions.
• Performs other duties as assigned.
• Regular and reliable attendance is required.

Competencies

Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate.

Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.

Creativity / Innovation: Ability to develop unique and novel solutions to problems; view change as necessary.

Empathy / Customer Service: Customer-focused behavior; helping approach, including listening skills, patience, respect, and empathy for another's position.

Information Management: Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.

Leadership: Successfully manage different styles of employees; provide clear direction and effective coaching.

Technical Skills: Knowledge of Military Health System (MHS) operations including deployments, contracting, and military training.

Company Overview

Taking Care of Our Nation's Heroes.

It's Who We Are. It's What We Do.

Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve®!

Our job is to make sure that America's heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.

Benefits

We're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

• Medical, Dental and Vision Coverage


• Generous paid time off


• 401(k) Retirement Savings Plan (with matching)


• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance


• Tuition reimbursement


• Paid volunteer time

*Annual salary average for CA residents is around $270,000 depending on experience

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.

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