Senior Project Manager, Group Medicare Operations

Blue Shield of CA; Virginia Beach (VA); Hybrid; USD 90,000 - 120,000; Full time

Job summary

The Group Medicare team is responsible for Client & Stakeholder Management, Retiree & Member Support Operations, Project Management & Execution, Compliance, Quality, & CMS Readiness, Data, Reporting & Continuous Improvement. In this role, you will help drive the operational excellence and continuous improvement of our Group Medicare offerings.

You will coordinate crossfunctional workstreams, streamline operational processes, and partner closely with internal teams and

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

• Coordinate crossfunctional workstreams and streamline operational processes.
• Partner with internal teams and external employer groups to enhance efficiency and experience.
• Support the retiree population and ensure highquality client and member support throughout the plan lifecycle.
• Drive operational excellence and continuous improvement of Group Medicare offerings.
• Report to the Program Manager and collaborate with leadership to develop leaders at all levels.

Skills

Project management

Cross-functional leadership

Stakeholder coordination

Operational process improvement

Lean Six Sigma

Process optimization

Education

Bachelor's degree or equivalent

Job description

The Group Medicare team is responsible for Client & Stakeholder Management, Retiree & Member Support Operations, Project Management & Execution, Compliance, Quality, & CMS Readiness, Data, Reporting & Continuous Improvement. In this role, you will help drive the operational excellence and continuous improvement of our Group Medicare offerings.

You will coordinate crossfunctional workstreams, streamline operational processes, and partner closely with internal teams and