Senior Group Medicare Program Manager (Hybrid)

Blue Shield of CA; Columbus (OH); Hybrid; USD 90,000 - 130,000; Full time

Job summary

Blue Shield of CA is seeking a Senior Project Manager on the Group Medicare team to drive operational excellence across retiree and member support, program management, and regulatory readiness.

You will coordinate crossfunctional workstreams, streamline processes, and partner with employer groups to enhance client and member experiences, while supporting CMS compliance and revenue outcomes.

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 with Group Medicare Advantage products strongly preferred.
• Experience with Employer Group Medicare Advantage and/or Employer Group Prescription Drug Plan 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) strongly preferred.
• Demonstrated success driving operational improvement efforts by leading crossfunctional teams.

Responsibilities

• Coordinate crossfunctional workstreams to drive operational excellence.
• Streamline operational processes and partner with internal teams and employer groups to enhance efficiency.
• Strengthen performance of our Group Medicare offerings and support retirees and members.
• Identify opportunities to improve how we deliver and sustain our programs.
• Report to the Program Manager and collaborate with senior leadership to achieve outcomes.

Skills

Program management

Project management

Operations

Healthcare administration

CMS regulations

Lean Six Sigma

Cross-functional coordination

Stakeholder management

Education

Bachelor's degree

Tools

Project management tools

Job description

Blue Shield of CA is seeking a Senior Project Manager on the Group Medicare team to drive operational excellence across retiree and member support, program management, and regulatory readiness.

You will coordinate crossfunctional workstreams, streamline processes, and partner with employer groups to enhance client and member experiences, while supporting CMS compliance and revenue outcomes.