About the Position: This position is located in Aurora CO.
Advanced Leave Accrual may be authorized.
Salary negotiation may be available for those candidates who are new to Federal service.
Student Loan repayment may be authorized.
Summary
About the Position: This position is located in Aurora CO.
Advanced Leave Accrual may be authorized.
Salary negotiation may be available for those candidates who are new to Federal service.
Student Loan repayment may be authorized.
Manage provider reimbursement policy and medical benefit programs for over 9 million TRICARE beneficiaries worldwide, with particular emphasis on value-based care initiatives, alternative payment models, and specialized demonstration projects.
Independently research, draft, and finalize authoritative, executive-level policy deliverables, including regulatory actions, legislative proposals, Department-level policy memoranda, Congressional responses, and contract modifications.
Utilizing large claims datasets, prospective payment systems, and industry-standard coding taxonomies (e.g., ICD-10, CPT, HCPCS, DRGs) to assess private sector program effectiveness and identify systemic healthcare cost and quality drivers.
Provide expert consultation and authoritative guidance to health care contractors on program medical benefit policy and reimbursement principles, policies, regulations and instructions.
Collaborate with interagency and private-sector partners (including CMS, VA, and commercial health insurers) on novel approaches to private sector health care delivery.
Serve as a key technical advisor to leadership and external authorities (such as the Department of Justice and GAO) on complex healthcare medical benefit policy and provider reimbursement.
Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation.
A Personnel Security Investigation is required.
This position requires you to submit a Public Financial Disclosure Report (OGE 278) or a Confidential Financial Disclosure Report (OGE450) upon entry, and annually thereafter.
Position is designated as Mission Essential. The incumbent will be required to report to work during times of contingency operations, natural disasters, extreme weather or other emergency situations.
Approximately 5% travel may be required. Travel may involve local, and or overnight.
Qualifications
Who May Apply: Only applicants who meet one of the employment authority categories below are eligible to apply for this job. You will be asked to identify which category or categories you meet, and to provide documents which prove you meet the category or categories you selected.
Current Civilian Employees of the Defense Health Agency (DHA)
Current Permanent Department of Defense (DoD) Civilian Employee
Executive Order (E.O.) 12721
Interagency Career Transition Assistance Plan
Land Management Workforce Flexibility Act
Military Spouses, under Executive Order (E.O.) 13473
Non-Appropriated Fund Instrumentality (NAFI)
Non-Department of Defense (DoD) Transfer
Office of Personnel Management (OPM) Interchange Agreement Eligible
People with Disabilities, Schedule A
Priority Placement Program, DoD Military Reserve (MR) and National Guard (NG) Technician Eligible
Priority Placement Program, DoD Military Spouse Preference (MSP) Eligible
Priority Placement Program, DoD MR and NG Preference Eligible Tech Receiving Disability Retirement
Priority Placement Program, DoD Retained Grade Preference Eligible
Reinstatement
Veterans Employment Opportunity Act (VEOA) of 1998
In order to qualify, you must meet the experience requirements described below. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document.
GS-13 Specialized Experience: One year of specialized experience which includes assisting in the design, implementation, or evaluation of private-sector health care delivery projects through quantitative or qualitative analyses; supporting the development and assessment of medical benefits and provider reimbursement, including alternative payment models; and producing data-driven documents that inform senior leaders on medical benefits and reimbursement. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-12).
Time in Grade Requirement: Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-12).
GS-14 Specialized Experience: One year of specialized experience which includes designing and implementing innovative private-sector health care programs using advanced quantitative or qualitative data analysis; providing expert guidance on medical benefits and provider reimbursement, including alternative payment models; and producing executive-level, data-driven documents that justify policy decisions and recommend actions related to private sector medical benefits or reimbursement to senior leaders. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-13).
Time in Grade Requirement: Applicants who have held a General Schedule (GS) position within the last 52 weeks must have 52 weeks of Federal service at the next lower grade or equivalent (GS-13).
Some federal jobs allow you to substitute your education for the required experience in order to qualify. For this job, you must meet the qualification requirement using experience alone--no substitution of education for experience is permitted.
You will be evaluated on the basis of your level of competency in the following areas:
Accountability
Attention to Detail
Customer Service
Decision Making
Flexibility
Influencing/Negotiating
Integrity/Honesty
Interpersonal Skills
Learning
Reading Comprehension
Reasoning
Self-Management
Stress Tolerance
Teamwork
Education
FOREIGN EDUCATION: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications.
Additional information
Male applicants born after December 31, 1959 must complete a Pre-Employment Certification Statement for Selective Service Registration.
You will be required to provide proof of U.S. Citizenship.
This position requires a 1 year probationary period during which the agency evaluates your fitness and whether your continued employment advances the public interest. In making this determination, the agency may consider your performance and conduct; agency needs and interests; whether your continued employment supports organizational or Government goals; and whether it promotes the efficiency of the Federal service. Continued employment requires written certification that it advances the public interest.
Direct Deposit of Pay is required.
This position requires you to submit a Public Financial Disclosure Report (OGE 278) or a Confidential Financial Disclosure Report (OGE450) upon entry, and annually thereafter.
Selection is subject to restrictions resulting from Department of Defense referral system for displaced employees.
Multiple positions may be filled from this announcement.
Salary includes applicable locality pay or Local Market Supplement.
If you have retired from federal service and you are interested in employment as a reemployed annuitant, see the information in the Reemployed Annuitant information sheet.
Payment of Permanent Change of Station (PCS) costs is not authorized, based on a determination that a PCS move is not in the Government interest.
Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.
You will be evaluated for this job based on how well you meet the qualifications above.
Once the announcement has closed, a review of your application package (resume, supporting documents, and responses to the questionnaire) will be used to determine whether you meet the qualification requirements listed on this announcement. Please follow all instructions carefully when applying, errors or omissions may affect your eligibility.
If, after reviewing your resume and/or supporting documentation, a determination is made that you have inflated your qualifications and/or experience, you may lose consideration for this position.
You may claim Military Spouse preference.
Military Spouse Preference (MSP) applicants will receive preference consideration and will be placed (if selected) at the highest grade for which they have applied and are determined best qualified, up to and including the full performance level.
You may claim Priority Placement Program (PPP) preference.
DoD Priority Placement Program (PPP) Applicants will receive preference consideration at the full-performance grade level only.
Interagency Career Transition Assistance Program (ICTAP). If you are a Federal employee in the competitive service and your agency has notified you in writing that you are a displaced employee eligible for ICTAP consideration, you may receive selection priority for this position. To receive selection priority, you must: (1) meet ICTAP eligibility criteria (2) be rated well-qualified for the position and; (3) submit the appropriate documentation to support your ICTAP eligibility. To be considered well-qualified and receive selection priority applicants must satisfy all qualification requirements for the position and receive a score of 90 or above. Additional information about the program is on OPM's Career Transition Resources website.
The documents you are required to submit vary based on the authority you are using to apply (i.e., applying as a veteran, applying as a current permanent Federal employee, applying as a reinstatement, etc). Please review the following links to see which documents you need to provide to prove your eligibility to apply: Applicant Checklist for Internal/MP Announcements (DoD)
As described above, your complete application includes your resume, your responses to the online questionnaire, and documents which prove your eligibility to apply. If you fail to provide these documents, you will be marked as having an incomplete application package and you will not be considered any further.
1. Your resume:
Your resume must be two pages or less and must support the specialized experience described in this announcement. Resumes exceeding two pages will be removed from consideration.
For each relevant work experience, make sure you include the employer's name, job title, start and end dates (include month and year), for qualifications purposes, the number of hours worked per week, and a brief description that show you can perform the tasks at the required level listed in the job announcement. If your resume does not contain this information, your application may be marked as incomplete, and you may not receive consideration for this position.
Use plain language. Avoid using acronyms and terms that are not easily understood. The hiring agency will not make assumptions about what's in your resume.
If your resume includes a photograph or other inappropriate material or content, it will not be used to make eligibility and qualification determinations, and you may not be considered for this vacancy.
Proof of Eligibility to Apply: Your application must include the documents which prove you are eligible to apply for the vacancy. The Proof of Eligibility document describes authorities commonly used in merit promotion recruitment and what document(s) are required to prove you meet the requirements of the authority. You must meet the requirements of at least one of the authorities listed in the Who May Apply section above to receive further consideration.
Time-in-grade documentation: If you are applying for a higher grade and your SF-50 has an effective date within the past year, it may not clearly demonstrate you meet the one year time-in-grade requirement so you will need to provide an SF-50 which clearly demonstrates you meet the time-in-grade requirements (examples of appropriate SF-50s include Promotions, Within-grade Grade/Range Increases, and SF-50s with an effective date more than one year old).
NOTE: Documents submitted as part of the application package, to include supplemental documents, may be shared beyond the Human Resources Office. Some supplemental documents such as military orders and marriage certificates may contain personal information for someone other than you. You may sanitize these documents to remove another person's personal information before you submit your application. You may be asked to provide an un-sanitized version of the documents if you are selected to confirm your eligibility.
To apply for this position, you must complete the online questionnaire and submit the documentation specified in the Required Documents section below.
The complete application package must be submitted by 11:59 PM (EST) on 10/26/2026to receive consideration.
To begin, click Apply to access the online application. You will need to be logged into your USAJOBS account to apply. If you do not have a USAJOBS account, you will need to create one before beginning the application (https://apply.usastaffing.gov/ViewQuestionnaire/13090081).
Follow the prompts to select your resume and/or other supporting documents to be included with your application package. As a reminder, your resume must be two pages or less and must support the specialized experience described in this announcement. Resumes exceeding two pages will be removed from consideration. For additional information, refer to the 'Required Documents' section.
You will have the opportunity to upload additional documents to include in your application before it is submitted. Your uploaded documents may take several hours to clear the virus scan process.
After acknowledging you have reviewed your application package, complete the Include Personal Information section as you deem appropriate and click to continue with the application process.
You will be taken to the online application which you must complete in order to apply for the position. Complete the online application, verify the required documentation is included with your application package, and submit the application. Your resume selected in USAJOBS will be included, but you must re-select other documents from your USAJOBS account or your application may be incomplete.
It is your responsibility to verify that your application package (resume, supporting documents, and responses to the questionnaire) is complete, accurate, and submitted by the closing date. Uploaded documents may take up to one hour to clear the virus scan.
Additional information on how to complete the online application process and submit your online application may be found on the USA Staffing Applicant Resource Center.
KF-DDAAFC DHA HQs
DO NOT MAIL
Falls Church, VA 22042
US
Next steps
If you provided an email address, you will receive an email message acknowledging receipt of your application. Your application package will be used to determine your eligibility, qualifications, and quality ranking for this position. If you are determined to be ineligible or not qualified, your application will receive no further consideration.
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
The documents you are required to submit vary based on the authority you are using to apply (i.e., applying as a veteran, applying as a current permanent Federal employee, applying as a reinstatement, etc). Please review the following links to see which documents you need to provide to prove your eligibility to apply: Applicant Checklist for Internal/MP Announcements (DoD)
As described above, your complete application includes your resume, your responses to the online questionnaire, and documents which prove your eligibility to apply. If you fail to provide these documents, you will be marked as having an incomplete application package and you will not be considered any further.
1. Your resume:
Your resume must be two pages or less and must support the specialized experience described in this announcement. Resumes exceeding two pages will be removed from consideration.
For each relevant work experience, make sure you include the employer's name, job title, start and end dates (include month and year), for qualifications purposes, the number of hours worked per week, and a brief description that show you can perform the tasks at the required level listed in the job announcement. If your resume does not contain this information, your application may be marked as incomplete, and you may not receive consideration for this position.
Use plain language. Avoid using acronyms and terms that are not easily understood. The hiring agency will not make assumptions about what's in your resume.
If your resume includes a photograph or other inappropriate material or content, it will not be used to make eligibility and qualification determinations, and you may not be considered for this vacancy.
Proof of Eligibility to Apply: Your application must include the documents which prove you are eligible to apply for the vacancy. The Proof of Eligibility document describes authorities commonly used in merit promotion recruitment and what document(s) are required to prove you meet the requirements of the authority. You must meet the requirements of at least one of the authorities listed in the Who May Apply section above to receive further consideration.
Time-in-grade documentation: If you are applying for a higher grade and your SF-50 has an effective date within the past year, it may not clearly demonstrate you meet the one year time-in-grade requirement so you will need to provide an SF-50 which clearly demonstrates you meet the time-in-grade requirements (examples of appropriate SF-50s include Promotions, Within-grade Grade/Range Increases, and SF-50s with an effective date more than one year old).
NOTE: Documents submitted as part of the application package, to include supplemental documents, may be shared beyond the Human Resources Office. Some supplemental documents such as military orders and marriage certificates may contain personal information for someone other than you. You may sanitize these documents to remove another person's personal information before you submit your application. You may be asked to provide an un-sanitized version of the documents if you are selected to confirm your eligibility.
To apply for this position, you must complete the online questionnaire and submit the documentation specified in the Required Documents section below.
The complete application package must be submitted by 11:59 PM (EST) on 10/26/2026to receive consideration.
To begin, click Apply to access the online application. You will need to be logged into your USAJOBS account to apply. If you do not have a USAJOBS account, you will need to create one before beginning the application (https://apply.usastaffing.gov/ViewQuestionnaire/13090081).
Follow the prompts to select your resume and/or other supporting documents to be included with your application package. As a reminder, your resume must be two pages or less and must support the specialized experience described in this announcement. Resumes exceeding two pages will be removed from consideration. For additional information, refer to the 'Required Documents' section.
You will have the opportunity to upload additional documents to include in your application before it is submitted. Your uploaded documents may take several hours to clear the virus scan process.
After acknowledging you have reviewed your application package, complete the Include Personal Information section as you deem appropriate and click to continue with the application process.
You will be taken to the online application which you must complete in order to apply for the position. Complete the online application, verify the required documentation is included with your application package, and submit the application. Your resume selected in USAJOBS will be included, but you must re-select other documents from your USAJOBS account or your application may be incomplete.
It is your responsibility to verify that your application package (resume, supporting documents, and responses to the questionnaire) is complete, accurate, and submitted by the closing date. Uploaded documents may take up to one hour to clear the virus scan.
Additional information on how to complete the online application process and submit your online application may be found on the USA Staffing Applicant Resource Center.
KF-DDAAFC DHA HQs
DO NOT MAIL
Falls Church, VA 22042
US
Next steps
If you provided an email address, you will receive an email message acknowledging receipt of your application. Your application package will be used to determine your eligibility, qualifications, and quality ranking for this position. If you are determined to be ineligible or not qualified, your application will receive no further consideration.
Fair and transparent
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
