Government Programs Operations Manager

Job Summary

Overseeing the implementation and optimization of Medicare, Medicaid, and Exchange programs, the full-time remote Government Programs Operations Manager will manage regulatory compliance, drive operational efficiencies, and lead a team in analyzing complex datasets to enhance program performance.

Key responsibilities

• Interpret and operationalize CMS/state regulatory guidance in collaboration with Compliance and internal SMEs
• Oversee the timely implementation of regulatory changes and coordinate cross-functional work plans
• Analyze complex encounter and PDE data to identify trends and opportunities for process improvement

Required qualifications

• 5+ years of healthcare data experience
• 5+ years of relevant PBM and/or Health Plan experience supporting Medicare Part D, Medicaid, or Exchange plans
• 5+ years of experience working with SQL, R, or Python
• Experience working with cross-functional teams
• Ability to balance multiple complex projects simultaneously