Program Analyst

Job Title

Program Analyst

Duties

Duties include:

• Prioritizing escalated provider issues related to unpaid claims for services provided and coordinates with Agency regional healthcare networks (i.e., Veterans Integrated Service Networks) and medical centers and contractors to resolve them.
• Monitoring appeals from providers within assigned geographic areas and provides support to the local Agency medical centers or third-party administrator as needed to ensure providers' issues are addressed.
• Communicating issues to stakeholders and helps create action plans to improve quality metrics and maintaining contact with stakeholders throughout the appeal process.
• Communicating and negotiating with internal and external stakeholders to accept and implement recommendations involving resources, required changes in established procedures, and impacts to the stakeholder; independently produces reports and documents per management's request.
• Conducting data analyses, data validations, and program analyses to assess the efficiency and effectiveness of processes in place at field facility associated with the Program Office's operations
• Analyzing trends for a range of initiatives (e.g., network adequacy, provider complaints, credentialing compliance) compared across Program Office geographic regions on a national level, identifying areas where deficiencies or irregularities that may need further review, research, and/or analysis to determine anomalies between sites.
• Quantitatively and qualitatively analyzing and evaluating the effectiveness of wider employing office operations in meeting established goals and objectives.
• Drafting responses to external inquiries and develops issue briefs, routing to appropriate management/staff as required.
• Making formal and informal presentations outlining the history, current status, and objectives of analyses and quality improvement functional responsibilities.
• Developing training content and associated presentation material to educate/inform Program Office partners (e.g., contractors, Agency field staff) on Program Office operations, policies, and processes related to provider network management administration.
• Administering and integrating the work of assigned project team members from different organizations for assigned projects to include scheduling, tracking progress, providing project and task status updates to project team members and management, and adhering to due dates and other requirements.
• Developing strategies that include considerations of current program operations, associated systems, and future initiatives.
• Other duties as assigned.

Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level.

Work Schedule: Full-time, 40 hours per week, Monday through Friday, 8 hours a day based on business needs

Telework: This position may be authorized for telework. Telework eligibility will be discussed during the interview process.

Position Description/PD#: Program Analyst/ PD05098A and PD56770A

Relocation/Recruitment Incentives: Not authorized.

Critical Skills Incentive (CSI): Not approved.

Permanent Change of Station (PCS): Not authorized.