Senior Group Medicare Program Manager

Blue Shield of CA; Seattle (WA); Hybrid; USD 110,000 - 140,000; Full time

Job summary

Blue Shield of CA is seeking a Senior Project Manager - Group Medicare (non-IT) to drive operational excellence across Medicare Advantage, Part D, and related programs. You will coordinate cross-functional teams, ensure CMS readiness, and partner with employer groups to deliver high-quality retiree and member support.

The role emphasizes collaboration, process optimization, and leadership in a hybrid workplace. A strong background in CMS regulations and healthcare operations is required.

Qualifications

• Bachelor's degree or equivalent combination of education and relevant work experience.
• 2
• 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

Responsibilities

• Drive operational excellence and continuous improvement of Group Medicare offerings.
• Coordinate crossfunctional workstreams and streamline operational processes.
• Partner with internal teams and external employer groups to enhance efficiency and elevate client and member experience.
• Support the retiree population and identify opportunities to improve how we deliver and sustain programs.

Skills

Project management

Operations management

Healthcare administration

CMS regulations

Compliance

Group Medicare

Cross-functional leadership

Process improvement

Lean Six Sigma

Education

Bachelor's degree

Job description

Blue Shield of CA is seeking a Senior Project Manager - Group Medicare (non-IT) to drive operational excellence across Medicare Advantage, Part D, and related programs. You will coordinate cross-functional teams, ensure CMS readiness, and partner with employer groups to deliver high-quality retiree and member support.

The role emphasizes collaboration, process optimization, and leadership in a hybrid workplace. A strong background in CMS regulations and healthcare operations is required.