TRICARE Resource Sharing Mgr at TriWest Healthcare Alliance in Phoenix, Arizona

Job Description:

Job Summary

The TRICARE Resource Sharing Manager is responsible for supporting the management of relationship with TriWest's key Resource Sharing subcontractor(s), and serves as one of the key points of contact for day-to-day performance monitoring, resolution of contractual-related issues, and participates in renegotiation of contract structure and setting and updating of performance standards regarding the TRICARE Resource Sharing program. The Manager assists with ensuring that the subcontractor fully understands and meets all regulatory and contract requirements, to include internal policies and procedures, and reports out to Senior Leadership on the performance against agreed upon standards. Manager will prepare business Case Analyses to support contracting decisions. In addition to monitoring performance across multiple locations, the Manager assesses, identifies and communicates opportunities for operational and management changes to achieve improved effectiveness, efficiencies and quality. The Manager diagnoses issues and develops solutions in conjunction with internal and primary subcontractor stakeholders to drive improved results. The Manager supports the management of multiple initiatives and teams in a fast-paced, dynamic environment across several locations.

Education & Experience

Required:

• Bachelor's degree in Business Administration, Finance or Health Care Administration or similar degree; or equivalent experience
• U.S Citizen
• Must be able to receive favorable Interim and adjudicated final Department of Defense (DoD) background investigation
• 5+ years contract management and/or health care operations oversight experience including ensuring meeting regulatory and contract requirements.
• Proven ability to execute across multiple locations and stakeholder groups
• Experience working on and influencing teams to produce desired outcomes
• Experience with data analysis, statistical analysis, process flow mapping and report design, including proficiency with database querying and the Microsoft Product Suite (specifically Word, Excel, PowerPoint, Project, and Visio)
• Experience working with operational planning at the department, division, or company-wide levels with a focus on developing performance metrics and tracking outcomes against objectives

Preferred:

• Resource sharing in health care administration or operations
• Healthcare experience and familiarity with medical terminology
• Experience with TRICARE Resource Sharing Program

Key Responsibilities

• Serves as one of the key points of contact to address contractual issues, renegotiates contract modifications and resolve disputes with Subcontractors.
• Manages relationship with the primary subcontractors, to include handling of day-to-day contact across multiple functional areas and reporting out to Senior Leadership on status of subcontractor performance, risks and opportunities.
• Participates in strategic discussions about relative value of make vs buy for contracted services and prepare Business Case Analyses to support these decisions.
• Provide direct oversight, guidance and support to primary subcontractor to ensure compliance with contract requirements, agreed upon services levels and customer service excellence standards.
• Ensures primary subcontractor fully understands and meets all regulatory requirements, professional best practices and industry standards, to include internal policies and procedures.
• Monitors government contracts and internal initiatives for modifications impacting operations and oversees vendor operations to ensure compliance to contract requirements and agreed upon standards.

• Determines the impact of government contract requirements and specific business initiatives on operations and communicates those impacts to primary subcontractor's stakeholders.
• Identifies and communicates opportunities for redefinition of operational and management processes based upon analyses of "lessons learned" in order to improve operations effectiveness and efficiency.
• Creates, manages and executes action plans, developed in conjunction with the primary subcontractor, to improve operations and adherence to contract standards.
• Communicates operational changes and training and program materials to primary subcontractor stakeholders for distribution to staff.
• Produces informative, easy-to-assimilate reports from the operational reporting systems, including written summary reports for Senior Leadership.
• Assists with special projects and other duties, as assigned by the Vice President of Contract Management or TriWest Senior Leadership.

Competencies

Communication / People Skills: Clearly presents information through spoken or written communication; effectively reads others and adapts communication patterns to multiple individual styles; demonstrates ability to influence or persuade others in positive or negative circumstances; ability to listen critically for relevant information; clearly demonstrate respect for others.

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

Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.

Independent Thinking / Self-Initiative: Critical thinker with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.

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

High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.

Multi-Tasking / Time Management: Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment.

Organizational Skills: Detail-oriented; ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources.

Team-Building / Team Player: Ability to influence the actions and opinions of others in a positive direction and build group commitment; adapt to different styles; listen critically; collaborate.

Technical Skills: Advanced knowledge of Microsoft Word, Excel, Project, PowerPoint, Visio, and SharePoint; ability to function without direction to produce outcomes within timelines; proficiency with statistical analysis, project management skills, data analysis, benchmarking, and quality improvement concepts; collaboration skills and team-oriented approach; presentations and meeting facilitation skills.

Working Conditions

Working Conditions:

• Availability to work non-regular hours, including weekends, as required
• Works within a standard office environment, with up to 10% travel
• Extensive computer work with long periods of sitting
• Onsite: Works within a standard office environment • Remote: Private and secure work space and work station with high speed internet is required

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

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.