Senior Project Manager, Group Medicare Operations

Blue Shield of CA; Hartford (CT); Hybrid; USD 90,000 - 140,000; Full time

Job summary

Blue Shield of CA is seeking a Project Manager, Senior - Group Medicare (non-IT) to drive operational excellence across Medicare Advantage and Part D initiatives. You will coordinate crossfunctional workstreams, streamline processes, and partner with internal teams and employer groups to enhance efficiency and client/member experience.

The role supports retirees, strengthens program performance, and seeks opportunities to improve delivery and sustainability of Group Medicare services.

Qualifications

• Minimum of 5 years of relevant experience in program management, project management, operations or healthcare administration.
• Experience with project management methodologies, tools and best practices.
• Experience in healthcare, managed care, health plan operations or Medicare-related operations.
• Knowledge of Medicare products, CMS regulations and compliance requirements.
• Experience with Group Medicare Advantage products preferred.
• Experience with Employer Group Medicare Advantage and/or EGWP/GPDP products preferred.
• Strong understanding of CMS requirements and annual readiness cycles.
• Lean Six Sigma certification with process improvement skills preferred.
• Proven ability to lead crossfunctional teams toward shared outcomes.

Responsibilities

• Coordinate crossfunctional workstreams and streamline operational processes.
• Collaborate with internal teams and external employer groups to improve efficiency and member experience.
• Strengthen performance of Group Medicare programs and support retirees.
• Identify opportunities to improve how services are delivered and sustained.

Skills

5+ years experience in program/project

PM methodologies/tools/best practice

Healthcare/Medicare operations

Medicare/CMS regulations/compliance

Group Medicare Advantage knowledge

EGWP/GPDP knowledge

CMS readiness cycles

Lean Six Sigma Black/Green Belt

Crossfunctional leadership

Education

Bachelor's degree or equivalent

Job description

Blue Shield of CA is seeking a Project Manager, Senior - Group Medicare (non-IT) to drive operational excellence across Medicare Advantage and Part D initiatives. You will coordinate crossfunctional workstreams, streamline processes, and partner with internal teams and employer groups to enhance efficiency and client/member experience.

The role supports retirees, strengthens program performance, and seeks opportunities to improve delivery and sustainability of Group Medicare services.