Summary
This position serves as Director of the Appeals Department within Veteran and Family Member Programs (VFMP), Office of Integrated Veteran Care, Veterans Health Administration, Department of Veterans Affairs (VA). The position provides national program support to the Secretary of the VA for VFMP Appeals managed activities per the Veteran Appeals Improvement and Modernization Act of 2017 (Pub L. 115-55), known as AMA. This position is organizationally aligned under the Deputy Director for VFMP.
Duties
Duties include, but not be limited to:
- Responsible and accountable for every aspect of AMA for VFMP health benefit programs, including policy, personnel, administration, operations, information technology, process, quality, budget, and change management.
- Ensures VFMP Appeals activities adhere to AMA; appeals activities covered include appeals intake, claims research, policy interpretation, determinations for Equitable Relief, notice of decision, duty to assist, and publishing information regarding the processing of appeals for all VFMP programs.
- Leads, directs, and supervises a staff of authorized full time equivalent employees (FTEE) engaged in managing implementation of Appeals per AMA for national and international health care benefit programs for Veterans and their eligible family members.
- Responsible for strategy, planning, organizing, directing, coordinating, controlling, reviewing, and evaluating every facet of VFMP appeals. Identifies, designs, implements, and verifies industry best practices and innovations of health care business solutions that might work to improve and advance VFMP appeals systems, per AMA…
