Health Systems Specialist
US Department of War
Job TitleJob DescriptionReviews and analyzes beneficiary case trends to identify systemic issues affecting TRICARE health service delivery.Provides expert technical assistance to DHA entities, MTF leadership, Uniformed Services, contractor representatives, and customer service personnel regarding TRICARE policy interpretation, operational requirements, and program procedures.Conducts independent analyses of TRICARE program implementation, operational performance, and compliance with federal and DoD requirements.Evaluates cases involving claims processing, enrollment, referral and authorization workflows, third-party liability, debt collection activities, and eligibility discrepancies to determine operational causes and recommend improvements.Develops and presents briefings, reports, and educational materials explaining TRICARE program updates, administrative changes, and system processes.
Vacancy posted 3 days ago
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