Medicare Operations Manager

Job Summary

A company is looking for a Manager of PBM Operations (Medicare).

Key Responsibilities

• Lead operational processes related to Medicare Part D, EGWP, and RDS, ensuring compliance and timely reporting
• Serve as the operational lead and liaison with external partners, monitoring performance and alignment with goals
• Support the development and execution of CMS application processes and enhance Medicare-related workflows

Required Qualifications

• Bachelor's degree required; advanced degree in healthcare administration, public health, or business is a plus
• 3-5 years of experience in PBM, Medicare Part D operations, or related healthcare services
• Strong knowledge of EGWP, RDS, and CMS application and reporting requirements
• Experience managing vendor relationships and contributing to delegated service oversight
• Demonstrated ability to work cross-functionally and lead operational projects independently