Senior Program Analyst, Federal Health

This is a fully remote position, open to applicants in Arizona, +25 more states.

📋 Description

• Act as a subject matter expert (SME) in the adjudication of VA disability benefits and analysis of federal programs.

• Convert extensive regulatory knowledge of VA disability rating criteria into organized business logic for training and validating AI models.

• Assess the sufficiency of evidence in VA disability claims.

• Assist in delivering federal program activities.

• Define and implement the regulatory and evidentiary standards for being Ready for Decision (RFD) across specific VA disability conditions.

• Create a comprehensive RFD Criteria Reference Guide that outlines evidentiary requirements in relation to 38 CFR Parts 3 and 4, as well as M21-1 adjudication standards.

• Review AI-generated determinations against claim files or synthesized data; evaluate accuracy, reasoning quality, and the proper identification of any missing or incomplete information.

• Examine AI-compiled medical records and related assessments for completeness and their validity against applicable rating criteria.

• Convert VA rating knowledge into structured business logic appropriate for AI model training and workflow validation.

• Maintain an Edge Case Log that records claim scenarios where AI determinations are incorrect or incomplete, including specific regulatory citations.

• Provide ad hoc SME consultation on condition-specific standards, updates to regulations, and pathways for claims development during program delivery.

⛳️ Requirements

• At least 2 years of direct experience in compensation claim rating as a VBA Rating Veteran Service Representative (RVSR).

• Broad understanding of high-volume VA disability condition types and prior experience as a subject matter expert, trainer, or quality reviewer within a VA program context.

• Expert-level knowledge of 38 CFR Part 3 (Adjudication) and Part 4 (Schedule for Rating Disabilities).

• Working familiarity with M21-1 adjudication procedures, including evidentiary sufficiency standards and Ready for Decision (RFD) criteria.

• Capability to evaluate the sufficiency of private medical records (PMR), service treatment records (STR), C&P exam reports, nexus opinions, buddy statements, and VA Form 201 (personnel file).

• Proficiency in translating complex regulatory knowledge into clear written outputs — such as analytical memos, documentation of criteria, and structured feedback — that are suitable for technology development teams and senior executive audiences.

• Ability to acquire and maintain a VA Public Trust clearance.

🏝️ Benefits

• Reasonable accommodations available for individuals with disabilities.

• Policies supporting equal employment opportunities.