Senior Project Manager, Group Medicare Operations

Blue Shield of CA; Portland (OR); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Blue Shield of California is seeking a Senior Project Manager for Group Medicare to drive operational excellence and coordinate crossfunctional workstreams. You will streamline processes and partner with internal teams and employer groups to enhance efficiency and client/member experience.

You will apply project management best practices within healthcare operations, focusing on Medicare products, CMS compliance, and readiness cycles, while supporting the retiree population we serve.

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 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

• Coordinate crossfunctional workstreams to drive operational excellence.
• Streamline operational processes to improve efficiency and reliability.
• Partner with internal teams and external employer groups to enhance client and member experience.
• Support the retiree population and ensure quality program delivery throughout the plan lifecycle.
• Lead and participate in continuous improvement initiatives across Group Medicare operations.

Skills

Cross-functional leadership

Process improvement

Education

Bachelor's degree

Job description

Blue Shield of California is seeking a Senior Project Manager for Group Medicare to drive operational excellence and coordinate crossfunctional workstreams. You will streamline processes and partner with internal teams and employer groups to enhance efficiency and client/member experience.

You will apply project management best practices within healthcare operations, focusing on Medicare products, CMS compliance, and readiness cycles, while supporting the retiree population we serve.