Job SummaryThe Subject Matter Expert (SME) – Program Implementation will provide strategic, operational, and implementation expertise supporting the Veterans Health Administration (VHA) Integrated Veteran Care (IVC) Veteran Family Member Programs (VFMP) Modernization Portfolio. This position supports enterprise modernization initiatives involving healthcare claims processing, eligibility modernization, appeals modernization, Electronic Data Interchange (EDI), workflow automation, data integration, operational transformation, and organizational process improvement.
The SME – Program Implementation will serve as a senior advisor and implementation lead supporting modernization initiatives across VFMP operational areas including intake, applications, claims adjudication, appeals, duty to assist, care coordination, benefits coordination, pharmacy operations, and nursing review functions. The role requires strong knowledge of healthcare operations, systems implementation, business transformation, governance, stakeholder engagement, and operational readiness.
This individual will work collaboratively with Government leadership, business stakeholders, technical teams, vendors, project managers, developers, analysts, and operational staff to ensure modernization solutions are successfully implemented, operationally aligned, and fully adopted across the organization.
The SME – Program Implementation will support strategic planning, implementation governance, business process redesign, operational integration, testing coordination, deployment readiness, and continuous process improvement activities supporting VFMP modernization objectives.
Primary Responsibilities
Program Implementation & Operational Modernization
- Support implementation of VFMP modernization initiatives impacting operational workflows, healthcare claims processing, eligibility systems, appeals modernization, automation, and EDI integration.
- Analyze current operational processes and future-state modernization requirements.
- Develop implementation strategies and operational transition plans supporting modernization initiatives.
- Coordinate implementation activities between operational teams, technical teams, vendors, and stakeholders.
- Ensure modernization initiatives align with VFMP governance standards, operational priorities, and business objectives.
- Support implementation of automation solutions designed to improve operational efficiency and reduce manual processing workloads.
- Assist in integrating modernization solutions into day-to-day operational workflows.
Business Process Analysis & Optimization
- Analyze existing operational workflows, business processes, and organizational structures.
- Conduct gap analyses between current-state and future-state operational environments.
- Identify opportunities for workflow optimization, automation, and operational efficiency improvements.
- Support development of business process redesign initiatives.
- Assist in documenting operational procedures, workflows, and modernization impacts.
- Evaluate modernization impacts on staffing, workload management, customer service, and operational performance.
Stakeholder Coordination & Governance
- Serve as a liaison between Government leadership, operational stakeholders, technical teams, and contractor personnel.
- Facilitate stakeholder meetings, working sessions, implementation reviews, and operational readiness discussions.
- Coordinate cross-functional collaboration among operational, technical, and business teams.
- Prepare executive briefings, status reports, recommendations, and implementation updates.
- Support governance reviews and leadership decision-making activities.
- Assist leadership in identifying risks, dependencies, and implementation barriers.
Requirements Development & Documentation
- Support gathering and validation of operational and technical business requirements.
- Assist in translating business requirements into implementation strategies and operational workflows.
- Ensure documentation complies with VFMP modernization governance and operational standards.
Testing, Deployment & Operational Readiness
- Support User Acceptance Testing (UAT) and end-to-end testing activities for modernization initiatives.
- Coordinate operational readiness assessments prior to implementation and deployment activities.
- Validate business functionality and operational workflows during testing activities.
- Assist with defect identification, issue resolution, and implementation troubleshooting.
- Support deployment planning, implementation scheduling, and post-implementation stabilization activities.
- Ensure operational teams are prepared for transition to modernized workflows and systems.
Minimum Qualifications
- Minimum five (5) years of experience supporting healthcare operations, program implementation, modernization initiatives, or enterprise transformation efforts.
- Bachelors Degree in Healthcare Administration, Business Administration, Public Administration, Information Systems, Health Informatics, Project Management or related field
- Experience supporting operational process improvement and business transformation initiatives.
- Experience coordinating implementation activities across multiple stakeholders and functional teams.
- Experience supporting operational readiness, deployment, or systems implementation efforts.
- Experience developing operational documentation, process flows, and implementation artifacts.
- Experience facilitating stakeholder meetings and cross-functional collaboration sessions.
