Job Description

Your Role

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 cross-functional workstreams, streamline operational processes, and partner closely with internal teams and external employer groups to enhance efficiency and elevate the overall experience for clients and members. Your work will directly strengthen the performance of our Group Medicare business, support the retiree population we serve, and identify opportunities to improve how we deliver and sustain our programs. The Project Manager, Senior - Group Medicare (non-IT) will report to the Program Manager.

The Group Medicare team serves retirees both inside and outside of California. We partner with employer groups and plan sponsors to offer Medicare Advantage and Medicare Part D solutions tailored to their retiring employees and eligible dependents. This role plays a key part in ensuring those clients-and their retirees-receive high-quality support throughout the plan lifecycle.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Responsibilities

Your Work

In this role, you will:

• Lead small-scale, high-impact operational initiatives involving multiple internal and external stakeholders to improve processes, enhance service delivery, and support business objectives
• Oversee the planning, development, and implementation of operational workflows and cross-functional business processes, ensuring teams collaborate effectively to deliver new or enhanced internal/external programs and services
• Manage programs from initiation through execution, ensuring operational readiness, consistency, and adoption, while driving continuous improvement across all projects within the program portfolio
• Coordinates interdepartmental activities to ensure operational projects stay on schedule and within budget, driving alignment across teams and maintaining momentum toward program goals
• Builds and leads project teams by assigning responsibilities, monitoring progress, and providing day-to-day operational guidance, ensuring effective collaboration and successful delivery of business initiatives
• Develop the program, integrated program plan, resource plan, contingency plan, and related project management artifacts
• Evaluate trade-offs between program size and complexity, cost, urgency, risk, and stakeholder value
• Validate financial forecasts and provide on-going reconciliation of resources and other related program expenditures
• Partner with business sponsors to define success metrics and criteria
• Assess and resolve all high priority program risks as they are encountered
• Ensure all projects adhere to project methodology compliance standards set by the company
• Serve as a subject matter expert to regularly brief key stakeholders on different aspects of assigned initiatives
• Represent the program in various project governance and inter-departmental forums
• Define and track program milestones while developing, maintaining, and reporting on an overall integrated delivery plan
• Manage operational and client-facing activities for the Group Medicare retiree line of business, ensuring smooth execution of implementations, annual readiness cycles, and ongoing plan updates
• Coordinate cross-functional teams to support accurate retiree enrollment processing, member communications, issue resolution, and alignment with CMS requirements
• Monitor Group Medicare performance trends and escalations, partnering with internal teams to drive improvements in service, compliance, and overall retiree experience
• Other duties as assigned

Qualifications

Your Knowledge and Experience

• Bachelor's degree or equivalent combination of education and relevant work experience required.
• Minimum of 5 years of relevant experience in program management, project management, operations, or healthcare administration
• Requires experience with project management methodologies, tools, and best practice
• Requires 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 required
• 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 cross-functional teams and coordinating multiple stakeholder groups toward shared business outcomes

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

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Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

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