Referral Management Program Administrator (O-6 Billet) Supervisory

Full Job Description

Serves as the Referral Management Program Administrator for ICE Health Service Corps, overseeing referral coordinators, off-site medical referrals, payment authorizations, and claims resolution.

Supervises staff, ensures compliance, manages program operations, and collaborates with internal and external stakeholders. Travel Required.

This position is only open to USPHS officers who are currently IHSC employees. USPHS Call to Active Duty (CAD) candidates are not eligible for this position.

PHYSICAL DEMANDS: Required to walk unaided at a normal pace for up to 5 minutes and maintain balance. Required to jog/fast walk up to 1⁄4 mile.

Required to perform CPR/emergency care standing or kneeling.

Must have the ability to assist sick, injured, or aging detainees or staff exiting the building (may require lifting, dragging, wheeling, or carrying someone who weighs significantly more than oneself).

Sitting and/or standing for extended periods of time [6-8 Hours]. Performing repeated bending motion.

Average manual dexterity for computer operation; able to endure the demands of consecutive hours of computer use and operation. Phone use for extended periods of time. Major Duties:

DUTIES AND RESPONSIBILITIES: Serves in the capacity of Referral Management Program Administrator (RMPA) and maintains subject matter expertise (SME) of the Referral Coordinator duties and responsibilities.

Directly supervises Referral Management Leads (RMLs) and is the government technical monitor (GTM) related to contract staff within the RMP.

As program administrator and SME, provides direct oversight of program activities, processes, and or policies related to: illegal alien off-site referrals, medical payment authorization requests, and related medical record acquisition, in support of and in collaboration with, all applicable IHSC services, divisions, units, programs and offices.

Supports general billing and coding principles, medical claim resolution processes within HPMU, and provider recruitment initiation as applicable.

Duties include day to day managing, assessing, planning, developing, budgeting, implementing, and evaluating assigned programs.

Incumbent reviews, revises, and, or writes policies; provides technical oversight on contracts; utilizes quality control measures to ensure compliance; formulates and executes short and long-range plans for optimum utilization of personnel; oversees and provides training; and facilitates program equipment acquisition and property management as applicable.

Overall responsibility for the successful planning, design, execution, monitoring, and management of the Referral Management Program (RMP) and related activities for referral/MedPARs for reimbursable health care services in collaboration with utilization management (UM), and medical claims for resolution.

The RMP is of a nationwide scope and importance and is essential for ICE detainee healthcare and the IHSC mission. Develops and submits monthly, quarterly and annual reports ( i.e.

strategic plan MAP/KPIs) training, Business Plan updates, quality assurance audits, etc. to the HPMU Unit Chief or designee.

Serves as a liaison between IHSC, VAFSC, and ICE ERO components in coordinating outside community-based specialty care for illegal aliens.

Coordinates and collaborates with internal and external stakeholders, including medical detention facility personnel, contractors, governmental and non-governmental public health entities.

Incumbent ensures compliance with related IHSC, ICE, detention, and industry regulations, standards, processes, procedures, and policy as applicable; maintains records per policy; chairs meetings; and coordinates and or manages programs within immediate organizational component.

Work purpose is primarily to further develop and maintain a standardized RMP; collaborate; supervise or provide government technical monitoring and oversight of government staff or contractor(s); advise, explain, interpret, and seek support for methods, policies and programs; and render a service of a moderately complex nature requiring a moderate amount of explanation and tact (e.g., support for budget).

As applicable, serves as supervisor or government technical monitor (GTM) of contractors or government employees (RMLs) in professional, technical, referral coordinator and or clerical roles in the conduct of all aspects of management (such as leave granting authority) of assigned functions related to administrative personnel management.

Accountable for addressing staffing needs of the RMP in collaboration with IHSC Personnel Unit, IHSC contracting officer representatives (CORs), and ICE contracting officers (COs) to maintain adequate program staffing coverage that meets mission and accommodates for TDY and leave absences.

Liaises regionally and or nationally with applicable internal and external stakeholders regarding processes, trainings, functions, and principles affiliated with the referral coordinator role, related HPMU program activities and duties as a GTM and or supervisor as applicable.

Provides orientation and guidance to the respective ICE, custody, and medical staff (contractors or government employees) at facilities in which ICE illegal aliens are held regarding ICE policies, reporting requirements, and applicable ICE detention standards.

Judgmental failure can result in ineffective or inappropriate use of resources and delays in meeting public health objectives of the office or agency.

This may also impair the development of systems, affect the work of contract staff or subordinate employees, and compromise the delivery of other administrative and personnel services.

Impact of error can cause serious impairment to a divisional/regional level program with a nationwide scope of importance.

Incumbent responsibilities as a GTM are commensurate with the complexity, value, technical direction, and monitoring required for a given contract.

The incumbent performs duties and complies with the responsibilities and limitations specified by the COR and contract specifications. Performs other duties and responsibilities as assigned.