Summary
This position is in the Veteran and Family Member Programs (VFMP), within Integrated Veteran Care (IVC). The Program Analysts reports to the Deputy Director, and is responsible for assisting with nation-wide family member pharmacy programs within IVC. The incumbent responds to internal/external customer requests and other related pharmacy program issues. Assists with program goals, objectives, policies and other guidelines for the Pharmacy Benefits Manager (PBM) and VA pharmacy programs.
Duties
Major Duties: Applies expertise in VFMP's pharmacy programs. Utilizes analysis to develop and improve upon business processes for all pharmacy programs to include eligibility, delivery of pharmacy claims, Rx claims processing, payment methodologies and remittance information. Works with the Customer Service Center on emerging pharmacy issues in customer service and provider relations. Identifies systematic problems, conducts studies, and analyzes/evaluates customer needs and develops specific solutions which mitigate future problems. Develops various feedback mechanisms (questionnaires, Surveys, etc.) which indicate the effectiveness of that service. Collects, compiles, maintains, and evaluates statistical data regarding the results of those feedback mechanisms, as well as type and frequency of all other Customer complaints and inquiries. Identifies trends that reflect existing, perceived or potential customer-related problem areas. Assists with the development and utilization of performance indicators and standards for the program and analyzes trends and reports results to directorate management. Develops possible innovative or modified work methods based off knowledge of VFMP operations, procedures, fiscal constraints, and management principles. Makes recommendations and/or provides Senior Program Analyst with objective information for making decisions. Performs reviews of pharmacy claims for payment accuracy and policy adherence. Performs weekly medication reviews of the additions to the MediSpan drug database to determine payment or nonpayment; keeping with adherences to Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) program policy. Identifies resource requirements and provides input to the Senior Program Analyst for the organization's annual operating budget submission process and monitors program cost factors and reports results to the Senior Program Analyst. The employee participates in the analysis of financial performance compared to projections and industry standards and as part of a team and develops and coordinates the implementation of VFMP pharmaceutical cost containment initiatives. Work Schedule: Monday- Friday, Tours between 6:00am-6:00pm Compressed/Flexible: May be available Telework: This position may be authorized for Ad-hoc telework. Ad-hoc Telework eligibility will be discussed during the interview process. Virtual: This position may be authorized for Virtual Work. Virtual Work eligibility is for current VA employees that are already subject to the return to the in-person work mandate in their current position. Definition of Virtual Work: Employee works outside of original hiring duty station at a VA-owned or leased space. Return to Office (RTO): RTO mandates are in effect and selectees will be required to report to in-person work unless they are approved for an exception or an exemption. Any approval for an RTO exception, exemption, or extension will happen after a conditional job offer, but before a final job offer. Position Description/PD#: Program Analyst/PD29830A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Approved
Requirements
You must be a U.S. Citizen to apply for this job To be considered for this position, you must complete all required steps in the process. In addition to the application and questionnaire, this position requires an online assessment. The online assessment measures critical general competencies required to perform the job. Selective Service Registration is required for males born after 12/31/1959 Physical Requirements: The work required does not inherently include any physical requirements essential for successful job performance that could not otherwise be performed with accommodation or workplace adjustment. A pre-placement physical examination is not required. Subject to background/security investigation Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period or 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider: your performance and conduct; the needs and interests of the agency; whether your continued employment would advance organizational goals of the agency or the Government; and whether your continued employment would advance the efficiency of the Federal service. Upon completion of your probationary period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.
Education
A transcript must be submitted with your application if you are basing all or part of your qualifications on education. Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.
How you will be evaluated
Your qualifications will be evaluated based on your application materials (e.g., resume, supporting documents), your responses on the application questionnaire, and your responses to all assessments required for this position. You will be assessed on the following Competencies for this position: Accountability Attention to Detail Customer Service Decision Making Flexibility Integrity/Honesty Interpersonal Skills Learning Reading Comprehension Reasoning Self-Management Stress Tolerance Teamwork Customer Service Interpersonal Skills Problem Solving Creative Thinking Analysis and Problem Solving Your experience must be fully documented on your resume and must include job title, duties, month and year start/end dates AND hours worked per week. A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Overstating your qualifications and/or experience in your application materials or application questionnaire may result in your removal from consideration. Cheating on the online assessment may also result in your removal from consideration. 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; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions.