Management and Program Analyst

Defense Health Agency•Aurora, CO

4d•Onsite

About The Position

This position is located in Aurora, Colorado, and manages provider reimbursement policy and medical benefit programs for more than 9 million TRICARE beneficiaries worldwide. The work emphasizes value-based care initiatives, alternative payment models, and specialized demonstration projects. The position independently researches, drafts, and finalizes authoritative, executive-level policy deliverables, including regulatory actions, legislative proposals, Department-level policy memoranda, Congressional responses, and contract modifications. The analyst uses large claims datasets, prospective payment systems, and industry-standard coding taxonomies such as ICD-10, CPT, HCPCS, and DRGs to assess private-sector program effectiveness and identify systemic drivers of healthcare cost and quality. The position provides expert consultation and authoritative guidance to healthcare contractors on medical benefit policy and reimbursement principles, policies, regulations, and instructions. It also collaborates with interagency and private-sector partners, including CMS, VA, and commercial health insurers, on approaches to private-sector healthcare delivery, and advises leadership and external authorities such as the Department of Justice and GAO on complex medical benefit policy and provider reimbursement. The position is designated Mission Essential, and the incumbent must report to work during contingency operations, natural disasters, extreme weather, or other emergencies. Approximately 5% travel may be required, including local or overnight travel. Advanced leave accrual and student loan repayment may be authorized; salary negotiation may be available to candidates new to Federal service.

Requirements

For GS-13, one year of specialized experience assisting in the design, implementation, or evaluation of private-sector healthcare delivery projects through quantitative or qualitative analysis; supporting development and assessment of medical benefits and provider reimbursement, including alternative payment models; and producing data-driven documents to inform senior leaders.
For GS-14, one year of specialized experience designing and implementing innovative private-sector healthcare programs using advanced quantitative or qualitative analysis; providing expert guidance on medical benefits and provider reimbursement, including alternative payment models; and producing executive-level, data-driven documents that justify policy decisions and recommend actions to senior leaders.
Applicants who held a General Schedule position within the previous 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent: GS-12 for GS-13, or GS-13 for GS-14.
Experience requirements must be met through experience alone; education cannot substitute for experience.
Applicants must belong to an eligible employment authority category and provide documentation establishing eligibility.
Appointment may require a suitability or fitness determination and a completed background investigation; a Personnel Security Investigation is required.
Submit a Public Financial Disclosure Report (OGE 278) or Confidential Financial Disclosure Report (OGE 450) upon entry and annually thereafter.
U.S. citizenship must be documented.
A one-year probationary period is required.
Direct deposit of pay is required.

Responsibilities

Manage provider reimbursement policy and medical benefit programs for TRICARE beneficiaries, with emphasis on value-based care, alternative payment models, and demonstration projects.
Research, draft, and finalize executive-level policy deliverables, including regulatory actions, legislative proposals, policy memoranda, Congressional responses, and contract modifications.
Analyze claims datasets, prospective payment systems, and healthcare coding taxonomies to evaluate private-sector programs and identify cost and quality drivers.
Provide expert guidance to healthcare contractors on medical benefit policy and provider reimbursement principles, policies, regulations, and instructions.
Collaborate with interagency and private-sector partners on approaches to private-sector healthcare delivery.
Advise leadership and external authorities, including the Department of Justice and GAO, on complex medical benefit policy and provider reimbursement.
Report to work during contingency operations, disasters, extreme weather, and other emergency situations.
Travel approximately 5%, which may include local and overnight travel.