Who We Are
Lawelawe is a Native Hawaiian Owned Small Disadvantaged Business (NHO SDB) that specializes in providing a range of services to federal government clients, including program management, digital solutions, human capital and training, and medical staffing. Lawelawe leverages our NHO status to secure federal contracts that not only drive business success but also support our overall mission to uplift economically disadvantaged Native Hawaiian families and preserve the Native Hawaiian heritage.

Who You Are
An experienced operational leader who can supervise personnel, coordinate competing priorities, and maintain accurate, timely performance in a sensitive healthcare-claims environment. You are organized, dependable, and comfortable managing workloads, resolving operational issues, mentoring employees, and communicating with Government stakeholders. You can support the Program Manager in daily operations and assume responsibility for contract performance when serving as the designated alternate.

How You Will Make An Impact
You will support the Defense Health Agency Office of General Counsel Claims Division and its Medical Affirmative Claims and Third-Party Collection programs. As Deputy Program Manager, you will assist with workforce supervision, workload distribution, hybrid scheduling, quality control, reporting, and operational coordination.

You will serve as the designated alternate Program Manager and oversee daily contract operations during the Program Manager’s absence. Your leadership will help maintain continuity of service and support the Government’s recovery of healthcare costs from liable third parties and third-party insurers.

Responsibilities

• Serve as the designated alternate Program Manager and assume responsibility for daily contract operations during the Program Manager’s absence.
• Assist the Program Manager with direct supervision, employee performance monitoring, staffing, attendance, leave coordination, and workforce development.
• Coordinate with the Government’s Contracting Officer’s Representative on performance, staffing, scheduling, and reporting matters as delegated or when acting as alternate Program Manager.
• Distribute and balance claims workloads based on case complexity, employee capacity, program priorities, and deadlines.
• Monitor shared organizational email inboxes and physical mail for incoming claims, correspondence, and inquiries.
• Process new referrals and establish Medical Affirmative Claims and Third-Party Collection case files.
• Enter claims and case information into ACMP and other required government systems.
• Maintain accurate electronic case files, tracking logs, correspondence, and supporting documentation.
• Research and collect authorized patient, beneficiary, treatment, billing, insurance, eligibility, and case-related information.
• Access medical, administrative, eligibility, and financial systems to obtain records, treatment timelines, billing statements, patient demographics, and related information.
• Verify patient and claim information and identify missing, inaccurate, or inconsistent data.
• Gather and organize medical records, accident reports, insurance information, billing data, and supporting documents for review.
• Properly name, index, upload, and maintain documents in SharePoint and government case-management systems.
• Record Third-Party Collection denial codes and payer responses.
• Complete standardized appeal templates and assemble appeal packages for higher-level review.
• Research potentially liable parties, insurance carriers, civilian attorneys, and other relevant entities.
• Prepare notices of claim using government-approved templates.
• Draft standard demand letters, settlement memoranda, and other routine correspondence for review and signature by authorized government personnel.
• Prepare and mail claims forms and supporting documentation when electronic submission is unavailable.
• Respond professionally to routine inquiries from insurance carriers, attorneys’ offices, healthcare organizations, government personnel, and other authorized parties.
• Provide approved, non-sensitive documentation in accordance with government direction.
• Update case status information within required timeframes.
• Track case milestones, correspondence, follow-up actions, payment activity, and statute-of-limitations deadlines.
• Perform data cleanup and first-level quality reviews of claims, reports, case files, and supporting documentation.
• Process cash collection vouchers and support the routing of recovered funds to the appropriate line of accounting.
• Verify payments, settlements, unpaid balances, and case status using authorized financial systems.
• Assist with collecting productivity, claims-processing, payment, and financial-recovery metrics for monthly reporting.
• Follow established standard operating procedures, quality control requirements, and supervisory direction.
• Perform other duties as assigned.

• At least five years of project or program management experience and five years of direct supervisory experience, including responsibility for employee performance, workload assignments, scheduling, coaching, and operational results. Supervisory experience may overlap with project or program management experience.
• Associate or bachelor’s degree in healthcare administration, business administration, paralegal studies, finance, insurance, or a related field is preferred.
• Experience overseeing daily contract operations and serving as the designated alternate Program Manager during the Program Manager’s absence, including maintaining operational continuity for a multi-person team.
• Experience balancing workloads, monitoring deadlines, resolving operational issues, implementing corrective actions, and coordinating staffing, leave coverage, hybrid-work schedules, and shared workspace usage.
• Ability to communicate professionally with Government personnel, insurance carriers, attorneys’ offices, and other stakeholders and to prepare accurate operational and performance reports.
• Availability to work an eight-hour shift within the contract’s 0600–1800 Central Time service window.
• Experience reviewing and processing medical records, billing statements, insurance documentation, claims correspondence, payment records, financial information, or similar documentation in accordance with detailed procedures.
• Familiarity with healthcare billing, third-party collections, insurance denials and appeals, payment verification, or healthcare cost-recovery activities.
• Strong attention to detail and the ability to independently manage multiple electronic case files, competing priorities, deadlines, correspondence, data entry, and document-control requirements.
• Experience working under established productivity, accuracy, timeliness, and quality-control standards.
• Ability to learn and maintain proficiency in Government claims, medical-record, eligibility, financial, and case-management systems, including ACMP, ABACUS, DEERS, GFEBS, JLV, MHS GENESIS, PEPR, SharePoint, or comparable systems.
• Experience supporting a federal healthcare program, Department of Defense organization, federal agency, or Government contractor is preferred.
• Experience safeguarding HIPAA-protected records, personally identifiable information (PII), protected health information (PHI), controlled unclassified information (CUI), or other sensitive Government information.
• Professional written and verbal communication skills, with proficiency in Microsoft Word, Excel, Outlook, Teams, and SharePoint.
• Must be a U.S. citizen and possess a Public Trust determination or the ability to successfully complete a Government background investigation.
• Must obtain and maintain a Common Access Card and all required Defense Health Agency system access.

• A competitive compensation package
• Comprehensive health and wellness benefits, including medical, dental, and vision plans
• Access to company-provided retirement savings options with matching contributions
• Opportunities for professional growth and continued learning
• Additional perks such as discounts on various services and products

Salary
Dependent on Experience (DOE). Compensation will be based on qualifications, relevant experience, and internal equity.

The above job description is intended to describe the general nature and level of work being performed by individuals assigned to this position. It is not intended to be an exhaustive list of all responsibilities, duties, and skills required. Candidates possessing the necessary qualifications for the position will be considered.

Lawelawe Training Services Inc is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status, and will not be discriminated against on the basis of disability.

Offers of employment are contingent upon satisfactory completion of a comprehensive background verification, inclusive of a criminal record check. Employment may be subject to other background checks, as required by the position.