Senior Group Medicare Program Manager

Blue Shield of CA; Miami (FL); Hybrid; USD 120,000 - 150,000; Full time

Job summary

Blue Shield of CA is seeking a Senior Project Manager to drive operational excellence within the Group Medicare team. You will coordinate crossfunctional workstreams, streamline processes, and partner with internal teams and employer groups to elevate efficiency and the client/member experience.

You will strengthen performance of Group Medicare programs, support retirees, and identify opportunities to improve delivery and readiness for CMS requirements.

Qualifications

• 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
• 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 preferred
• Experience 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 preferred
• Lean Six Sigma Green Belt or Black Belt certification (or equivalent process improvement training) preferred
• Demonstrated success driving operational improvement efforts by leading crossfunctional teams and coordinating multiple stakeholder groups toward shared business outcomes

Responsibilities

• Coordinate crossfunctional workstreams across groups to drive operational efficiency.
• Streamline operational processes to improve client and member experience.
• Partner with internal teams and external employer groups to deliver highquality Medicare services.
• Help strengthen performance of Group Medicare offerings and support retirees.
• Identify opportunities to improve how we deliver and sustain CMS readiness.

Skills

Project management

Operations management

Healthcare administration

CMS compliance

Crossfunctional teamwork

Lean Six Sigma Green Belt

Education

Bachelor's degree

Job description

Blue Shield of CA is seeking a Senior Project Manager to drive operational excellence within the Group Medicare team. You will coordinate crossfunctional workstreams, streamline processes, and partner with internal teams and employer groups to elevate efficiency and the client/member experience.

You will strengthen performance of Group Medicare programs, support retirees, and identify opportunities to improve delivery and readiness for CMS requirements.