Capital Rx

Government Program Operations Specialist

Capital Rx$72K — $91K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 1-3 years of experience in operations, program coordination, or healthcare administration, ideally with Medicare or managed care exposure.
  • Associate's or Bachelor's degree preferred; minimum of a high school diploma required.
  • Strong organizational skills with a keen attention to detail, especially in documentation and quality reviews.
  • Ability to manage multiple tasks effectively within tight deadlines, including coordinating meetings and tracking deliverables.
  • Familiarity with ticketing systems and project management tools is essential.
  • Experience in testing and quality assurance processes is a plus.
  • Excellent written and verbal communication skills, capable of summarizing complex issues and communicating clearly with various stakeholders.

Responsibilities

  • Create and organize program documentation, ensuring accuracy and compliance with standards.
  • Track and monitor enhancement requests and technical development progress to meet project timelines.
  • Support system and process testing to validate functionality and adherence to business specifications.
  • Conduct quality assurance reviews of member communications for accuracy and compliance.
  • Ensure timely completion of client reporting by tracking deliverables and service level agreements (SLAs).
  • Identify and escalate issues or discrepancies within program operations to facilitate effective resolution.
  • Coordinate meetings and manage agendas, notes, and follow-up on action items.

Benefits

  • Flexible work environment with a hybrid model available.
  • Opportunities for collaboration and engagement with cross-functional teams.
  • Supportive culture emphasizing compliance and quality assurance in healthcare operations.
Full Job Description
Hybrid (Local to New York, NY, Denver, CO or Charlotte, NC) **Position Summary** The Government Programs Operations Specialist (MPPP) provides operational and administrative support to ensure the successful coordination, implementation, and ongoing management of the Medicare Prescription Payment Plan (MPPP) program. This role focuses on organizing program activities, creates and maintains program level documentation, and supporting cross-functional teams to meet regulatory, client, and internal requirements. The Specialist also assists with tracking and testing technical development work, and supports quality assurance reviews for member communications, invoices, and program materials to promote compliance and accuracy. This position is critical to maintaining efficient program operations and mitigating risks associated with growth, compliance, and client expectations. **Position Responsibilities:** - Create, maintain and organize program documentation, including SOPs, job aides, FAQs, and control documentation. - Submit and track development tickets; monitor progress and follow up to ensure timely completion of enhancements and fixes. - Support testing of system(s) or process updates to validate functionality and ensure outcomes meet business requirements. - Support quality assurance reviews of member notices, invoices and other communications to ensure accuracy, completeness, and compliance. - Track deliverables, timelines, and service level agreements (SLAs) to ensure timely completion of client reporting and program outputs. - Monitor program activities and escalate issues, risks, or discrepancies; assist in issue tracking and remediation efforts - Coordinate internal and external (client) meetings; prepare and maintain meeting agendas, notes, and action item tracking. **Required Qualifications:** - 1-3 years of experience in operations, program coordination, healthcare administration, or a related role (Medicare, PBM, or managed care experience preferred). - Associate's or Bachelor's degree preferred; High school diploma or equivalent required. - Strong organizational skills with demonstrated attention to detail and accuracy, particularly in documentation, tracking, and quality review activities. - Experience managing multiple workstreams, including meeting coordination, task tracking, and deliverable management in a deadline-driven environment. - Familiarity with ticketing systems, project tracking tools, or workflow management platforms - Experience supporting testing, quality assurance, or validation activities for operational processes, systems, or communications preferred. - Exposure to healthcare regulatory or compliance environments (e.g., CMS, Medicare, notices, audits) is a plus. - Strong written and verbal communication skills, including the ability to document meeting outcomes, summarize issues, and communicate with cross-functional teams and clients. - Proven ability to work both independently and collaboratively across teams while managing competing priorities. New York, NY Salary Range $87,000-$109,000 USD Denver, CO Salary Range $80,000-$100,000 USD Charlotte, NC Salary Range $72,800-$91,000 USD All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

About Capital Rx

Capital Rx is a healthcare company that provides pharmacy benefit management services to self-insured employers. The company's technology platform, RxNova, allows employers to manage their pharmacy benefits and provides real-time data analytics. Capital Rx was founded in 2017 and is headquartered in Charleston, SC.
Learn more about Capital Rx
Size
50 employees
Industry

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