Senior Group Medicare Program Manager - Operations

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

Job summary

Blue Shield of CA is seeking a Senior Project Manager for Group Medicare to drive operational excellence across retirement and member support programs. You will coordinate crossfunctional workstreams, streamline processes, and collaborate with employer groups and internal teams to enhance efficiency and client satisfaction.

The role emphasizes CMS readiness, compliance awareness, and leveraging Lean Six Sigma to deliver measurable improvements.

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.
• Knowledge of Medicare products, CMS regulations, compliance requirements, and operational processes.
• Experience with Group Medicare Advantage products is strongly preferred.
• Experience with Employer Group Medicare Advantage and/or EGWP/GPDP products preferred.
• Strong understanding of CMS requirements, compliance standards, and annual readiness cycles.
• Lean Six Sigma Green Belt or Black Belt certification (or equivalent) with problem-solving and process optimization.

Responsibilities

• Coordinate crossfunctional workstreams to drive operational excellence for Group Medicare offerings.
• Streamline operational processes and partner with internal teams and employer groups.
• Support CMS readiness and compliance across the program lifecycle.
• Lead stakeholder coordination to achieve shared business outcomes.

Skills

Program management

Project management

Cross-functional collaboration

CMS regulations

Lean Six Sigma

Stakeholder management

Education

Bachelor's degree

Job description

Blue Shield of CA is seeking a Senior Project Manager for Group Medicare to drive operational excellence across retirement and member support programs. You will coordinate crossfunctional workstreams, streamline processes, and collaborate with employer groups and internal teams to enhance efficiency and client satisfaction.

The role emphasizes CMS readiness, compliance awareness, and leveraging Lean Six Sigma to deliver measurable improvements.