Project Manager, Senior - Group Medicare (Non-IT)

Blue Shield of CA; Hartford (CT); Hybrid; USD 90,000 - 140,000; Full time

Job summary

Blue Shield of CA is seeking a Project Manager, Senior - Group Medicare (non-IT) to drive operational excellence across Medicare Advantage and Part D initiatives. You will coordinate crossfunctional workstreams, streamline processes, and partner with internal teams and employer groups to enhance efficiency and client/member experience.

The role supports retirees, strengthens program performance, and seeks opportunities to improve delivery and sustainability of Group Medicare services.

Qualifications

• Minimum of 5 years of relevant experience in program management, project management, operations or healthcare administration.
• Experience with project management methodologies, tools and best practices.
• Experience in healthcare, managed care, health plan operations or Medicare-related operations.
• Knowledge of Medicare products, CMS regulations and compliance requirements.
• Experience with Group Medicare Advantage products preferred.
• Experience with Employer Group Medicare Advantage and/or EGWP/GPDP products preferred.
• Strong understanding of CMS requirements and annual readiness cycles.
• Lean Six Sigma certification with process improvement skills preferred.
• Proven ability to lead crossfunctional teams toward shared outcomes.

Responsibilities

• Coordinate crossfunctional workstreams and streamline operational processes.
• Collaborate with internal teams and external employer groups to improve efficiency and member experience.
• Strengthen performance of Group Medicare programs and support retirees.
• Identify opportunities to improve how services are delivered and sustained.

Skills

5+ years experience in program/project

PM methodologies/tools/best practice

Healthcare/Medicare operations

Medicare/CMS regulations/compliance

Group Medicare Advantage knowledge

EGWP/GPDP knowledge

CMS readiness cycles

Lean Six Sigma Black/Green Belt

Crossfunctional leadership

Education

Bachelor's degree or equivalent

Job description

Your Role

The Group Medicare team is responsible for Client & Stakeholder Management, Retiree & Member Support Operations, Project Management & Execution, Compliance, Quality, & CMS Readiness, Data, Reporting & Continuous Improvement. In this role, you will help drive the operational excellence and continuous improvement of our Group Medicare offerings. You will coordinate crossfunctional workstreams, streamline operational processes, and partner closely with internal teams and external employer groups to enhance efficiency and elevate the overall experience for clients and members. Your work will directly strengthen the performance of our Group Medicare business, support the retiree population we serve, and identify opportunities to improve how we deliver and sustain our programs. The Project Manager, Senior - Group Medicare (non-IT) will report to the Program Manager.

The Group Medicare team serves retirees both inside and outside of California. We partner with employer groups and plan sponsors to offer Medicare Advantage and Medicare Part D solutions tailored to their retiring employees and eligible dependents. This role plays a key part in ensuring those clients-and their retirees-receive highquality support throughout the plan lifecycle.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

• Bachelor's degree or equivalent combination of education and relevant work experience required.
• Minimum of 5 years of relevant experience in program management, project management, operations, or healthcare administration
• Requires experience with project management methodologies, tools, and best practice
• Requires experience within healthcare, managed care, health plan operations, or Medicare-related business operations
• Demonstrated knowledge of Medicare products, CMS regulations, compliance requirements, and operational processes required
• Experience working on Group Medicare Advantage products strongly preferred
• Experience working with Employer Group Medicare Advantage and/or Employer Group Prescription Drug Plan (EGWP/GPDP) products preferred
• Strong understanding of CMS requirements, compliance standards, and annual readiness cycles strongly preferred
• Lean Six Sigma Green Belt or Black Belt certification (or equivalent process improvement training) with demonstrated ability to apply structured problem-solving and process optimization techniques strongly preferred
• Demonstrated success driving operational improvement efforts by leading crossfunctional teams and coordinating multiple stakeholder groups toward shared business outcomes

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

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