Jr. Requirements Specialist (TRICARE Encounter Data (TED) System)

Position Summary: The Junior Requirements Specialist provides technical assistance to the Senior Requirements Specialist in the oversight, maintenance, and management of the TRICARE Encounter Data (TED) System. Operating under general supervision, this role supports the DHA Health Plan Operations Support Section (HPOSS) by performing routine reviews to evaluate contractor performance, conducting system research, and analyzing issues related to health care program, policy, and benefits management. The Junior Specialist applies strong foundational analytical skills and detail-oriented data analysis to support system integrity and data quality, collaborating closely with Senior Specialists, Managed Care Support Contractors (MCSCs), developers, and other business stakeholders., System Support & Initial Analysis

· Assist in the development of TRICARE Encounter Data (TED) system edits to enforce new and changed policies, benefits, and pilot/demonstration programs.

· Perform routine research and analysis of algorithms, edits, mapping, and daily Edit Error Summary Reports to assist in monitoring contractor performance.

· Research and analyze recurring TED edit errors to identify potential system issues, reporting findings and proposed solutions to senior team members.

· Produce, monitor, and run daily reports for both the Benchmark Test environment and Production data cycles (processing over 500,000 records daily) to identify potential error trends.

· Support the maintenance and update of the TRICARE System Manual (TSM) TED edit documents to reflect policy transitions and pilot programs.

Testing & Quality Control Assistance

· Conduct routine random sampling of processed records to verify that edits and programs are functioning according to established business rules, and escalate complex technical errors to system developers and senior staff.

· Perform random sampling of processed TED records to verify the accuracy of data downloaded and reported by the Defense Enrollment Eligibility Reporting System (DEERS).

· Assist in the development of test criteria and test case scenarios to facilitate the testing of system changes for new Demonstrations and Pilots.

· Assist in monitoring active record testing in the Benchmark environment to verify changes before they are deployed to the Production environment.

· Support Contract Transition activities by monitoring and analyzing daily TED Benchmark testing records and compiling results for the Senior Specialist and HPOSS leadership.

· Monitor, track, and document errors in the Benchmark test environment during the launch of new programs, producing daily status updates.

Data Maintenance & Administrative Support

· Help maintain, update, and implement approved changes to over seventy (70) TED Reference Files (RF), including Special Processing Codes, Procedure Codes, Diagnosis Codes, Revenue Codes, and DEERS OGP Type Codes.

· Assist the TRICARE Duplicate Claims System team by using Business Objects Web Intelligence to extract specific records and data sets as requested.

· Draft written responses to routine verbal or written inquiries from staff, contractors, and external government agencies for review by senior team members.

Stakeholder Coordination

· Serve as an initial point of contact to assist MCSCs, Contracting Officers (COs), and Contracting Officer Representatives (CORs) in troubleshooting and resolving rejected records due to edit errors.

· Inform the Senior Specialist and HPOSS leadership of recurring MCSC challenges or emerging system issues.

· Assist in compiling quantitative and qualitative data to support recommendations for process controls and contract approach improvements.

· Bachelor’s degree in Healthcare Administration, Information Systems, Business Analysis, or a related field, or equivalent entry-to-mid-level professional experience.

· Strong foundational analytical abilities with a keen attention to detail, specifically in reviewing structured healthcare or transactional data.

· Familiarity with data extraction tools (e.g., Business Objects Web Intelligence or similar SQL/reporting tools) and basic database/system architectures.

· Ability to follow detailed analytical procedures, perform root-cause research, and systematically troubleshoot technical issues.

· Effective written and verbal communication skills for documenting test findings, drafting procedural responses, and coordinating with multidisciplinary teams., * Bachelor’s (Required), * Data analytics: 2 years (Required)

4.54.5 out of 5 stars 16401 East Centretech Parkway, Aurora, CO 80011 Hybrid work $54,000 - $64,000 a year - Full-time, Pulled from the full job description

• Referral program
• Professional development assistance
• 401(k)
• Health insurance
• 401(k) matching
• Paid time off
• Vision insurance, Insignia is required by law in some jurisdictions to include a reasonable estimate of the compensation range for this role. The determination of this range includes various factors not limited to skill set, experience level, relevant training, geographic location and licensure and certifications. This is not a guarantee of compensation or salary, as the final offer amount may vary based on the above factors. Compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range for this role in the Aurora, CO area is $54,000 - $64,000.

Pay: $54,000.00 - $64,000.00 per year, * 401(k)

• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Professional development assistance
• Referral program
• Vision insurance

Insignia Federal Group is a woman-owned small business dedicated to delivering high-quality, personalized consulting services to both private and public sector clients. Since 2003, we have specialized in strategic planning, program management, contracts and acquisition support, training, and professional IT services, ensuring our clients’ challenges are addressed swiftly and effectively.