Mgr Tricare Site

Health Net, Inc. (NYSE: HNT) is among the nation’s largest publicly traded managed health care companies.  Health Net’s mission is to help people be healthy, secure and comfortable.  The company’s POS, HMO, insured PPO, behavioral health and government contracts subsidiaries provide health benefits to more than 7 million individuals.  For more information on Health Net, Inc., please visit the company’s Web site at www.healthnet.com

 

JOB SUMMARY:

 

The TRICARE Site Manager is responsible for operation and management of the Scott AFB TRICARE Service Center (TSC) and supervising the staff assigned to the TSC.  Also plays a key role in Military Treatment Facility (MTF) optimization and in day to day interface with the MTF Commander and staff.  This individual will monitor and report changes in MTF capacity and capability that impact balanced workload agreements; supervise TSC enrollment-related functions to include monitoring MTF capacity and network needs; supervises a specialty referral intake process, and a program to retrieve the results of specialty consultations sent out to civilian network providers.  Also supervises a small TSC located in St. Louis; plans, organizes and accomplished network provider education/relations in service area; provides or supports beneficiary briefings; MTF provider education and the provider relations program as needed.  This position reports to the Director, Field Optimization.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

 The Manager, TRICARE Site manages and directs TRICARE Service Center operations to include onsite customer
service, education and briefings, MTF interface and support and direct supervision of assigned TRICARE Community
Representative, TRICARE Service Advocates, and Referral Management Center Liaison.  Participates in MTF optimization activities to include planning meetings to develop enrollment, Resource Sharing and
network development strategies that support optimal use of MTF resources.Manages MTF and network provider education and relations program for the prime service area, ensuring required
educational briefings and onsite provider visits are delivered when and where required.




REQUIREMENTS:

 

Education:

Bachelor's degree in Business, Healthcare Administration or related field (equivalent combination of education and related experience will be considered)

 

Experience:

3-5 years of managed care support contractor TSC experience preferred OR 5+ years experience working with the military health care system OR 3-5 years experience of supervising and directing associate daily work activities

 

Knowledge, Skills and Abilities:Thorough knowledge and understanding of the military healthcare system and TRICARE program to include, MTF interface requirements, TSC operations, enrollment guideline/processing, marketing/education, eligibility/benefits provider relations program.  Strong supervisory skills with the ability to build and maintain effective teams.  Customer service/problem solving skills. Verbal/written communication skills to include ability to provide educational briefings to small and medium sized beneficiary and provider audiences.

 As a government contractor, this position requires U.S. citizenship or proof of favorable adjudication following submission of Department of Defense form SF85P or higher security.

 

Health Net, Inc. supports a drug-free work environment and requires pre-employment background and drug screening.
 
Health Net and its subsidiaries are an Equal opportunity/Affirmative Action Employer M/F/V/D.