Senior Group Medicare Project Manager - Ops & Improvement

Blue Shield of CA; Washington (District of Columbia); Hybrid; USD 120,000 - 150,000; Full time

Job summary

Blue Shield of CA seeks a Senior Project Manager for Group Medicare to drive operational excellence across client and stakeholder management, retiree and member support operations, and CMS readiness. You will coordinate crossfunctional workstreams, streamline processes, and partner with employer groups to enhance efficiency and the member experience.

You will lead projects with a focus on compliance, quality, and continuous improvement, reporting to the Program Manager and guiding teams through

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 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 our Group Medicare offerings.
• Coordinate crossfunctional workstreams, streamline operational processes, and partner with internal teams and external employer groups to enhance efficiency and the member experience.
• Support the retiree population and ensure high-quality support throughout the plan lifecycle.
• Lead crossfunctional teams and coordinate multiple stakeholder groups toward shared business outcomes.
• Report to the Program Manager and contribute to CMS readiness cycles.

Skills

Program management

Project management

Operations management

Cross-functional teamwork

Process improvement

Education

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

Tools

Lean Six Sigma Green Belt

Job description

Blue Shield of CA seeks a Senior Project Manager for Group Medicare to drive operational excellence across client and stakeholder management, retiree and member support operations, and CMS readiness. You will coordinate crossfunctional workstreams, streamline processes, and partner with employer groups to enhance efficiency and the member experience.

You will lead projects with a focus on compliance, quality, and continuous improvement, reporting to the Program Manager and guiding teams through