Government Programs Operations Manager – Analysis & Efficiencies - Remote

Overview

The Government Programs Operations Manager is responsible for overseeing the implementation, compliance, and optimization of Medicare, Medicaid, and Exchange programs. This position blends regulatory expertise with operational innovation to ensure that government program operations are both compliant and technically efficient.

In Short

• Lead a team to identify, develop, and maintain technical analysis and efficiencies.
• Design automated solutions and validate the accuracy of deliverables.
• Establish scalable processes supporting regulatory and business objectives.
• Interpret CMS and state guidance, ensuring alignment with regulatory intent.
• Drive data-informed decision-making by analyzing complex datasets.
• Collaborate with cross-functional teams to enhance operational capabilities.
• Monitor internal operations and implement corrective actions.
• Support claims correction activities and audits.
• Maintain comprehensive documentation and reporting specifications.
• Foster a high-performance culture through mentorship and collaboration.

Requirements

• 5+ years of healthcare data experience.
• 5+ years of PBM and/or Health Plan experience supporting Medicare Part D, Medicaid, or Exchange plans.
• 5+ years of experience with SQL, R, or Python.
• Experience working with cross-functional teams.
• Ability to balance multiple complex projects simultaneously.
• Extremely flexible and highly organized.
• Attention to detail and commitment to high-quality work.
• Excellent written and verbal communication skills.
• Ability to foster a culture of collaboration and high performance.

Benefits

• Opportunity to work in a flexible environment.
• Engagement in meaningful healthcare initiatives.
• Collaboration with a diverse team of professionals.
• Professional development opportunities.
• Competitive salary and benefits package.