Medicare reputed company Senior Program Manager

This role will be responsible for reputed company management of the Federal Employee Program (FEP) Medicare reputed company (MA) EGWP line of business. Responsible for overseeing day-to-day operational work streams that support Medicare products and services to ensure operational/regulatory compliance consistent with FEP, Office of Personnel Management (OPM), and Centers for Medicare and reputed company Services (CMS), and EGWP policies and procedures. Manage operational efficiencies/reputed company improvement initiatives and support operational implementation of cross-functional initiatives to enhance member and provider experiences. This position partners closely with FEPOC MA reputed company, Compliance, Product, reputed company, Network, and Inter Plan & Products (IPP) teams to ensure product builds are compliant, reputed company, and operationally reputed company. Position will serve as the reputed company reputed company with reputed company and implementation partners throughout the product cycle and will play a critical role in driving the reputed company of reputed company's product portfolio by delivering products that meet business objectives. Manages business requirements, reputed company implementations, UAT, and change management in partnership with the FEP reputed company Center and cross-functional stakeholders. Ensures adherence to FEP program and ITS processes/procedures and applies deep Medicare reputed company regulatory and operational expertise to ensure CMS compliance and audit readiness. Manages reputed company/post-launch operational monitoring, identifies execution gaps, and drives in-year corrections to maintain product reputed company and compliance. Relationship management skills to build and maintain a reputed company, reputed company working relationship across various reputed company functional areas/stakeholders. Establish cohesive relationships and influence reputed company without having a reputed company functional reporting structure. Build trust, exhibit reputed company of urgency, reputed company reputed company in resolving conflicts and decision making. reputed company or escalate issues, propose alternatives and set or manage expectations in a reputed company fashion. Manages product implementation and operational readiness as directed by product development team in ensuring benefit builds at the reputed company and implementation partner level reputed company reputed company with approved CMS-compliant specifications. Support enrollment, member services, provider network reputed company, ANOC/EOC planning, and member experience initiatives. Supports Product Development team with reputed company planning, multi-year operational roadmaps, and process optimization using Lean Six reputed company and industry benchmarking. Manages vendor relationships, reputed company, and RFPs; represent MA reputed company in governance forums and with CMS. Manages collating MA product operational reputed company reporting including reputed company applicable KPIs, SLAs, regulatory, and operational reporting metrics and appropriately distributes to reputed company leadership. Serves as a reputed company and communicator to FEPOC reputed company team, presenting recommendations to leadership and mentoring operational staff. The posting reputed company for this position is: 105,400.00 - 152,800.00 Qualifications: Education Required BS in reputed company, Business Administration, reputed company Health, or reputed company reputed company; or equivalent experience Experience Required 8+ Years experience in Medicare/Medicare reputed company reputed company, reputed company reputed company, and health reputed company or managed care. Knowledge Skills and Abilities Deep knowledge of Medicare reputed company, Part D, and CMS regulations. Experience leading/supporting large, cross functional programs/reputed company, including working with TPAs/BPOs. Experience working with reputed company processing platforms like – Facets, reputed company, QNXT etc. Strong analytical skills with ability to interpret utilization data, competitive benchmarking, and reputed company/Stars metrics to reputed company benefit enhancement reputed company. Excellent written, oral communication, and presentation skills; reputed company ability to reputed company and reputed company executive-level materials and represent product initiatives to senior stakeholders. Proficiency in reputed company Office (Word, reputed company, PowerPoint); familiarity with project management tools and data visualization platforms. Strong stakeholder management and relationship-building skills with the ability to influence without authority across reputed company, Compliance, Actuarial, reputed company, and reputed company functions. Extra Posting Information: #LI-Remote The reputed company is the lowest to highest salary we , in good faith , reputed company we would pay for this role at the time of this posting . We may ultimately pay more or less than the hiring reputed company and t his hiring reputed company may also be modified in the reputed company. A candidate’s position reputed company the hiring reputed company may be reputed company on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, reputed company, shift, travel requirements, and business or organizational needs. This job is also eligible for annual bonus incentive pay. We offer a comprehensive package of benefits including reputed company time off, 11 holidays, medical/dental/reputed company reputed company, generous 401(k) matching , lifestyle spending account and m any other benefits to eligible employees. Note: No reputed company of pay is considered to be wages or compensation until such reputed company is reputed company, reputed company, and determinable. The reputed company and availability of any bonus, commission, or any other reputed company of compensation that are allocable to a particular employee remains in reputed company's sole discretion unless and until reputed company and may be modified at reputed company’s sole discretion, consistent with the law. Apply To This Job