Health Plan Operations Subject Matter Expert
Remote
Part Time to Full Time
Healthcare
Experienced
Subject Matter Expert – Health Plan Operations
Position Summary
Cetechs is seeking a Subject Matter Expert (SME) for Health Plan Operations. The Subject Matter Expert (SME) in Health Plan Operations will execute tasks that includes but not limited to the development and communication of value-based care pilot designs and implementation strategies. The SME will ensure compliance with legislative requirements and act as a strategic partner to VA leaders, policymakers, and stakeholders on policy and operational matters relevant to current and future pilot initiatives.
Key Responsibilities
Position Summary
Cetechs is seeking a Subject Matter Expert (SME) for Health Plan Operations. The Subject Matter Expert (SME) in Health Plan Operations will execute tasks that includes but not limited to the development and communication of value-based care pilot designs and implementation strategies. The SME will ensure compliance with legislative requirements and act as a strategic partner to VA leaders, policymakers, and stakeholders on policy and operational matters relevant to current and future pilot initiatives.
Key Responsibilities
- Lead the design, implementation, and evaluation of value-based care pilots in accordance with legislative requirements.
- Communicate progress, challenges, and implementation strategies to key internal and external stakeholders, ensuring alignment and understanding of objectives.
- Support the development, optimization, and oversight of business processes to facilitate efficient and compliant program operations.
- Conduct rigorous analysis of existing and future pilot implementations, identifying operational gaps and opportunities for improved outcomes.
- Advise on the preparation of policy updates, legislative reports, and responses to information requests from governing bodies and oversight entities.
- Engage with policymakers, the Government Accountability Office (GAO), and the Office of Inspector General (OIG) as needed to support Congressionally mandated Veterans Health Administration (VHA) initiatives.
- Provide expertise in navigating and managing VHA national clinical and business programs, contributing to system-wide improvements and innovations.
- Master’s degree in Health Administration, Public Health, Business, or related field.
- Minimum of 10 years’ experience with senior leadership roles in VA healthcare systems, including in both rural and urban settings.
- At least 8 years’ operational experience at a VA Medical Center and/or within a Veterans Service Integrated Network (VISN).
- Demonstrated experience leading Congressionally mandated VHA initiatives.
- Experience coordinating activities with policymakers, GAO, OIG, and program oversight entities.
- Track record managing national VHA clinical and business programs.
- Deep familiarity with VA health system operations, value-based care, and federal healthcare legislative processes.
- Excellent written and verbal communication skills for stakeholder engagement and complex report preparation.
- Advanced analytical, strategic, and organizational abilities.
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