Operational Leader, Healthcare Claims & Government Programs

Lawelawe Training Services Inc; San Antonio (TX); Hybrid; USD 95,000 - 130,000; Full time

Benefits offered by this job

Competitive pay

Health benefits

Retirement plan with matching

Professional growth

Discounts

Job summary

Lawelawe Training Services Inc is seeking an experienced Deputy Program Manager to supervise staff, coordinate workloads, and maintain performance in a sensitive healthcare-claims environment. You will support the Defense Health Agency and act as the alternate Program Manager to sustain contract operations.

You will lead workforce management, distribution of claims, and reporting while ensuring timely, accurate processing and compliance with government systems and templates.

Qualifications

• Five years of project or program management experience and five years of direct supervisory experience.
• Degree in healthcare administration, business, paralegal studies, finance, or related field preferred.
• Experience overseeing daily contract operations and serving as alternate Program Manager.
• Experience balancing workloads, deadlines, staffing, and hybrid-work scheduling.
• Ability to communicate professionally with Government personnel, insurers, and stakeholders.
• Availability to work an eight-hour shift within the 0600-1800 Central Time window.
• Experience reviewing medical records, billing statements, and claims documentation.
• Familiarity with healthcare billing, third-party collections, denials, and appeals.
• Strong attention to detail and ability to manage multiple electronic case files.

Responsibilities

• Serve as the designated alternate Program Manager and oversee daily contract operations during the PM's absence.
• Supervise staff, monitor performance, staffing, attendance, and workload distribution.
• Coordinate with the Government’s COR on performance, staffing, scheduling, and reporting.
• Distribute and balance claims workloads based on case complexity and deadlines.
• Manage shared email inboxes and physical mail for claims and inquiries.
• Create and maintain Medical Affirmative Claims and Third-Party Collection case files.
• Enter case information into ACMP and other required government systems.
• Maintain electronic case files, logs, and supporting documentation.
• Collect and organize medical records, insurance data, and billing information.
• Name, index, and upload documents in SharePoint and case-management systems.
• Record denial codes and payer responses for Third-Party collections.
• Prepare appeal templates and assemble packages for higher-level review.
• Research liable parties and carriers for collections and cost-recovery.
• Prepare notices of claim and draft demand letters and settlement memoranda.
• Generate reports and track case milestones, timelines, and payments.
• Follow SOPs and quality control requirements; perform other duties as assigned.

Skills

Project management

Supervisory experience

Healthcare / claims operations

Government contracting

Communication with stakeholders

Hybrid work coordination

Education

Associate or Bachelor's degree in healthcare administration, business administration, paralegal studies, finance, insurance, or related field

Tools

ACMP

ABACUS

DEERS

GFEBS

JLV

MHS GENESIS

PEPR

SharePoint

Job description

Lawelawe Training Services Inc is seeking an experienced Deputy Program Manager to supervise staff, coordinate workloads, and maintain performance in a sensitive healthcare-claims environment. You will support the Defense Health Agency and act as the alternate Program Manager to sustain contract operations.

You will lead workforce management, distribution of claims, and reporting while ensuring timely, accurate processing and compliance with government systems and templates.