Field Support Specialist - Hybrid - Colorado Springs, CO

Hybrid schedule supporting Military Treatment Facilities (MTFs) at Ft Carson, Peterson, USAFA, and Buckley. This Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation. Veterans, Reservists, Guardsmen, and military family members are encouraged to apply.

About the Role

This position resides within the Military and Veteran Services (MVS) division and supports the internal staff of military treatment facilities (MTFs). The incumbent will work closely with MTF staff to support TRICARE beneficiaries, providing non-clinical support for patient referrals and authorizations, outreach to network providers, and facilitating support from applicable TriWest departments for resolving network gaps, provider and contract concerns, customer service requests, and discharge coordination. The role also involves providing TRICARE educational briefings and assisting with MTF contingency exercises or actual scenarios. Frequent coordination with Provider Relation Representatives is required to determine TRICARE-certified healthcare locations. This position reports to the MVS Regional Director and may require travel to multiple MTFs or regional TriWest hubs.

Responsibilities

• Develop and maintain a clear understanding of TriWest’s contracted responsibilities, the TRICARE Operations Manual, and performance requirements related to MTF and beneficiary support.
• Serve as the designated onsite/on-call TriWest point of contact for MTF staff regarding enrollment, referrals, authorizations, network provider issues, beneficiary claims, and related matters.
• Utilize TriWest’s CRM system, DOMA, Government Portal, DEERS, and Tableau to refer identified issues to appropriate TriWest divisions for resolution, following MVS operating procedures.
• Report urgent matters via phone to applicable directors/departments and through the CRM system.
• Monitor referred issues for trends or opportunities to improve TriWest’s services, identifying root causes of recurring matters and keeping the Regional Director informed.
• Review and facilitate resolution of referral and authorization issues, analyzing root causes and collaborating with MTF staff to implement corrective strategies.
• Provide onsite support and act as a liaison between the referral operations team and MTFs to resolve discrepancies in referral and authorization inquiries.
• Use the medical management platform to review and update existing referrals and authorizations.
• Deliver TRICARE information/education briefings for MTF staff, providers, medical staff, and beneficiary groups, explaining TRICARE health plans and policies.
• Perform on-site and virtual outreach activities for military installation communities and beneficiary groups (e.g., Family Readiness Groups, Retiree Associations, Newcomers Orientation), providing educational briefings on TRICARE enrollment, PCM selection, and related topics.
• Document and record performance of educational briefings for contract performance reporting per MVS policy.
• Partner with MTF staff to identify and develop opportunities for MTF optimization in support of Defense Health Agency (DHA) Network goals.
• Assist MTF staff, the Regional Director, and MVS team members with contingency planning for MTF exercises or actual scenarios.
• Maintain up-to-date knowledge of the Managed Care Support Contract, contract changes, the TRICARE Operations Manual (TOM), and TriWest policies and procedures.
• Maintain proficiency in TriWest’s CRM system, ensuring it is used to record and report customer service transactions and issues.
• Input potential quality of care or safety issues into CRM and report them to the Regional Director and applicable departments per MVS policy.
• Consistently meet productivity and performance metrics as determined by TriWest and MVS policy.
• Perform other duties as assigned; regular and reliable attendance is required.

Requirements

• High School Diploma or General Education Diploma (GED).
• U.S. citizenship and ability to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation.
• 2+ years of experience working with the TRICARE Program in customer service and administrative support for clinical operations and provider services or equivalent roles.
• Demonstrated success working in a highly matrixed organizational environment.

Preferred Qualifications

• Bachelor’s Degree in a health-related field (e.g., Health Administration, Health Policy, Public Health, Public Administration, or Communications).
• Experience as a TRICARE Beneficiary Counseling and Assistance Coordinator (BCAC).
• Experience working in MTF TRICARE business operations.
• Experience with CARE Radius, DOMA (Document Management System), and DEERS (Defense Enrollment Eligibility Reporting System).

Skills

• Commitment to Task: Ability to conform to established policies and procedures; high motivation.
• Communication/People Skills: Ability to influence or persuade others, adapt to different styles, listen critically, and collaborate.
• Information Management: Ability to manage large amounts of complex information, communicate clearly, and draw sound conclusions.
• Organizational Skills: Ability to organize people or tasks, adjust priorities, learn systems within time constraints, and attention to detail.
• Problem Solving/Analysis: Ability to solve problems through systematic analysis and sound judgment; realistic understanding of relevant issues.
• Team-Building/Team Player: Ability to influence others positively and build group commitment.
• Technical Skills: Working knowledge of medical terminology and the authorization/referral process; advanced telephone customer service and analysis skills; proficiency with data entry into online systems; ability to work in a fast-paced production environment using multiple systems.

Working Conditions

• Hybrid schedule with remote work and travel to MTFs and TriWest hubs; may be assigned to a specific MTF or a hybrid position (home/MTF/hub).
• Frequent travel expected.
• Availability to be reached by MTF staff or TriWest team members via phone during normal working hours.
• Extensive computer and telephone work.

Benefits

• Medical, dental, and vision coverage.
• Paid time off.
• 401(k) Retirement Savings Plan with company matching.
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance.
• Tuition reimbursement.
• Paid volunteer time.
• Frequent pay raises, overtime opportunities, recognition, and reward programs.

Pay

This position typically ranges from $72,000 to $85,000 per year, depending on role and location.