Program Analyst

Veterans Health Administration•Lakewood, CO

About The Position

This position is in the Veteran and Family Member Programs (VFMP), within Integrated Veteran Care (IVC). The Program Analyst reports to the Deputy Director and assists with nationwide family member pharmacy programs within IVC. The incumbent responds to internal and external customer requests and addresses related pharmacy program issues, while assisting with program goals, objectives, policies, and guidelines for the Pharmacy Benefits Manager (PBM) and VA pharmacy programs. The role applies expertise in VFMP pharmacy programs to analyze and improve business processes, including eligibility, pharmacy-claim delivery and processing, payment methodologies, and remittance information. It supports customer service and provider relations, identifies and investigates program and customer issues, and develops solutions, feedback mechanisms, performance measures, and reports. The analyst also reviews pharmacy claims and medication database additions for payment accuracy and policy adherence, supports budget planning and cost monitoring, and participates in financial analysis and pharmaceutical cost-containment initiatives. The work schedule is Monday through Friday, with tours between 6:00 a.m. and 6:00 p.m. Compressed or flexible scheduling may be available. Ad-hoc telework may be authorized, and virtual work may be authorized for eligible current VA employees subject to the return-to-office mandate. Selectees are generally expected to report in person unless approved for an exception or exemption. Relocation and recruitment incentives, critical skills incentives, and permanent change of station are not authorized or approved.

Requirements

U.S. citizenship is required.
Meet the applicable time-in-grade requirement, if applicable: for GS-11, 52 weeks at GS-09 in Federal service.
Meet the specialized-experience requirement with one year of experience equivalent to at least GS-09, such as collecting and analyzing program data, reviewing business processes, supporting program administration and customer service, maintaining records, and collaborating with stakeholders; or qualify through the stated education or combination of education and experience options.
If qualifying based on education, provide transcripts; only qualifying education from accredited institutions is accepted.
Register for Selective Service if applicable to males born after December 31, 1959.
Complete the required application steps and online assessment.
Complete required background/security checks and onboarding requirements.
Participate in the seasonal influenza vaccination program as a Department of Veterans Affairs Health Care Personnel employee.
Serve a one-year probationary period or two-year trial period, as applicable.
No specific physical requirements are inherent to the work that cannot otherwise be performed with accommodation or workplace adjustment.

Responsibilities

Apply expertise in VFMP pharmacy programs.
Analyze and improve business processes for pharmacy programs, including eligibility, pharmacy-claim delivery and processing, payment methodologies, and remittance information.
Work with the Customer Service Center on emerging pharmacy issues involving customer service and provider relations.
Identify systematic problems, conduct studies, evaluate customer needs, and develop solutions to mitigate future problems.
Develop feedback mechanisms, such as questionnaires and surveys, to assess service effectiveness.
Collect, maintain, and evaluate feedback data, as well as data on the types and frequency of customer complaints and inquiries.
Identify trends indicating existing, perceived, or potential customer-related problem areas.
Assist in developing and using program performance indicators and standards; analyze trends and report results to directorate management.
Develop possible new or modified work methods based on VFMP operations, procedures, fiscal constraints, and management principles.
Make recommendations and provide objective information to the Senior Program Analyst to support decisions.
Review pharmacy claims for payment accuracy and adherence to policy.
Review weekly additions to the MediSpan drug database to determine payment or nonpayment in accordance with CHAMPVA program policy.
Identify resource requirements, provide input to the Senior Program Analyst for the annual operating budget submission, and monitor and report program cost factors.
Participate in analysis of financial performance against projections and industry standards.
Work as part of a team to develop and coordinate implementation of VFMP pharmaceutical cost-containment initiatives.