Remote Government RFI Operations Manager

Profile We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only). Our Department of Defense contract requires U.S. citizenship and a favorably adjudicated DOD background investigation for this position. Veterans, Reservists, Guardsmen, and military family members are encouraged to apply. Job Summary Under the direction of the Director, Request for Info (RFI), ePMO, this manager oversees the response process for Requests for Information (RFI) submitted by government customers, including the Defense Health Agency (DHA), Congressional offices, and other federal stakeholders. The role involves close coordination with TriWest leadership and internal staff on complex, high‑visibility beneficiary, Veteran, and TRICARE member cases. Responsibilities include day‑to‑day operational oversight of written RFI correspondence and ad‑hoc reporting requests, ensuring compliance with TRICARE contract requirements and DHA reporting standards while maintaining contract performance metrics and stakeholder confidence. Education & Experience Required: High School diploma or GED U.S. Citizenship Must be able to receive a favorable interim and adjudicated final Department of Defense (DoD) background investigation At least two years of progressively responsible experience in health care complex case coordination, including managing complex case programs At least two years of supervisory experience Experience in investigating and/or responding to escalated issues or complaints Experience working with VA and/or DoD health care programs (CCN/TRICARE) Excellent proven oral and written communication skills Strong working knowledge of MS Office Preferred: Bachelor's (BA/BS) Degree in Business Administration, Healthcare, Social Work, or equivalent experience Experience in the health care industry Solid understanding of HIPAA, related privacy laws, and security measures for safeguarding PHI and PII Key Responsibilities Serve as the internal primary point of contact and manager for day‑to‑day operations of Requests for Information and government ad‑hoc reporting requests. Manage identification of TRICARE inquiries for inclusion in priority response programs and escalation of select cases for high‑touch engagement by other department staff. Manage intake of requests, clarification of requests, identification of subject matter experts, workload distribution, monitoring against deadlines, and trending of issues and risks. Collaborate with the Director, Request for Info (RFI), ePMO on escalations and mitigation of issues and risks. Serve as the first review for routine responses and collaborate with the Director on complex responses. Manage templates, department desk procedures, and workflows. Respond to complex RFIs and ad hoc report requests. Create policies and procedures, program reports, and development plans, and coordinate with Data Management staff on ongoing improvements to data analysis and reporting of RFI written correspondence and ad hoc reporting data. Hire and manage staff, including interviewing and selection following approval by the Director and senior TriWest leadership; onboard, develop, and conduct performance management. In collaboration with the Director, develop, organize, and implement strategic communications with internal leadership and across all internal departments. Manage the preparation of reporting required for TriWest leadership awareness. Work with TriWest administrative, operational, and clinical staff and leadership as required to ensure proper response to all RFI written correspondence cases and ad hoc reporting requests. Interface with all levels of TriWest employees in a knowledgeable manner and maintain professional working relationships. Perform other duties as assigned. Regular and reliable attendance is required. Competencies Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapts to different styles; listens critically; collaborates. Communicates tactfully and professionally with all levels of leadership in relation to the primary mission. Translates technical and clinical content into clear written communications appropriate for federal audiences. Recurring contact with internal staff and external stakeholders. Computer Literacy: Ability to function in a multi‑system Microsoft environment using Word, Outlook, the TriWest Intranet, the Internet, and department software applications. Creativity / Innovation: Ability to develop unique and novel solutions to problems; views change as necessary. Empathy / Customer Service: Customer‑focused behavior; helping approach including listening skills, patience, respect, and empathy for another's position. Independent Thinking / Self‑Initiative: Critical thinker with the ability to focus on what matters most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources. Leadership: Receives general supervision from the Director, Request for Info (RFI), ePMO, with broad objectives and significant latitude for independent action. Provides direct supervision to the Government RFI Analyst and any additional analyst staff assigned to the function. Sets standards for response quality, timeliness, and contract compliance, and holds the team accountable to those standards. Multi‑Tasking / Time Management: Prioritizes and manages actions to meet changing deadlines and requirements within a high volume, high stress environment. Organizational Skills: Ability to organize people and tasks, adjust to priorities, and learn systems within time constraints and with available resources; detail‑oriented. Problem Solving / Analysis: Solves problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues and identifies root causes of recurring response challenges. Team‑Building / Team Player: Influences the actions and opinions of others in a positive direction and builds group commitment. Technical Skills: Thorough understanding of healthcare claims processing; knowledge of the Defense Health Agency and/or VA Health Care System and TriWest's systems, policies, and procedures; grievance and health care correspondence processing; research and analysis skills; trend identification and documentation; editing skills. Working Conditions Availability to work non‑standard hours Work within a standard office environment, with moderate travel Extensive computer work with long periods of sitting Benefits Medical, Dental and Vision Coverage Paid time off 401(k) Retirement Savings Plan (with matching) Short‑term and long‑term disability, basic life, and accidental death and dismemberment insurance Tuition reimbursement Paid volunteer time TriWest job postings typically include a salary range, which can vary based on the specific role and location, but generally this position ranges from around $112,000 - $118,000 per year. Equal Employment Opportunity TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that supports diversity at every organizational level, and we highly encourage candidates from all backgrounds to apply. Applicants are considered for positions based on merit and without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws. #J-18808-Ljbffr TriWest Healthcare Alliance