Senior Group Medicare Project Lead

Blue Shield of CA; Phoenix (AZ); Hybrid; USD 95,000 - 135,000; Full time

Job summary

Blue Shield of CA seeks a Senior Project Manager - Group Medicare (non-IT) to drive operational excellence across the Group Medicare portfolio. You will coordinate cross-functional workstreams, streamline processes, and partner with internal teams and employer groups to enhance efficiency and member experience throughout the plan lifecycle.

The role requires 5+ years in program/project management within healthcare, strong CMS regulation knowledge, and Lean Six Sigma expertise.

Qualifications

• Bachelor's degree or equivalent combination of education and relevant work experience.
• Minimum of 5 years of program/ project management experience in healthcare or related field.
• Experience with PM methodologies, tools, and best practices.
• Experience in healthcare operations or Medicare-related business operations.
• Knowledge of Medicare products, CMS regulations, and compliance.
• Experience with Group Medicare Advantage and EGWP/GPDP is preferred.
• Strong CMS readiness and regulatory compliance understanding.
• Lean Six Sigma certification (Green/Black Belt) or equivalent training preferred.
• Proven ability to lead cross-functional teams and coordinate multiple stakeholders.

Responsibilities

• Drive operational excellence and continuous improvement of Group Medicare offerings.
• Coordinate cross-functional workstreams and streamline processes.
• Partner with internal teams and employer groups to enhance efficiency and member experience.
• Strengthen performance of Group Medicare programs and support retirees.
• Identify opportunities to improve delivery and sustainability of programs.

Skills

Project management

Healthcare operations

Cross-functional leadership

CMS compliance

Lean Six Sigma

Education

Bachelor's degree

Tools

Project management tools

Job description

Blue Shield of CA seeks a Senior Project Manager - Group Medicare (non-IT) to drive operational excellence across the Group Medicare portfolio. You will coordinate cross-functional workstreams, streamline processes, and partner with internal teams and employer groups to enhance efficiency and member experience throughout the plan lifecycle.

The role requires 5+ years in program/project management within healthcare, strong CMS regulation knowledge, and Lean Six Sigma expertise.