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

Blue Shield of CA; Washington (District of Columbia); Hybrid; USD 120,000 - 150,000; Full time

Job summary

Blue Shield of CA seeks a Senior Project Manager for Group Medicare to drive operational excellence across client and stakeholder management, retiree and member support operations, and CMS readiness. You will coordinate crossfunctional workstreams, streamline processes, and partner with employer groups to enhance efficiency and the member experience.

You will lead projects with a focus on compliance, quality, and continuous improvement, reporting to the Program Manager and guiding teams through

Qualifications

• Bachelor's degree or equivalent combination of education and relevant work experience.
• Minimum of 5 years of relevant experience in program management, project management, operations, or healthcare administration.
• Experience with project management methodologies, tools, and best practice.
• 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.
• 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.

Responsibilities

• Drive operational excellence and continuous improvement of our Group Medicare offerings.
• Coordinate crossfunctional workstreams, streamline operational processes, and partner with internal teams and external employer groups to enhance efficiency and the member experience.
• Support the retiree population and ensure high-quality support throughout the plan lifecycle.
• Lead crossfunctional teams and coordinate multiple stakeholder groups toward shared business outcomes.
• Report to the Program Manager and contribute to CMS readiness cycles.

Skills

Program management

Project management

Operations management

Cross-functional teamwork

Process improvement

Education

Bachelor's degree or equivalent combination of education and relevant work experience

Tools

Lean Six Sigma Green Belt

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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