Senior Manager, Government Program Operations
Capital Rx
Cloud
Salary
💰 $100,000 - $125,000 per year
Job Level
Mid-LevelSenior
Tech Stack
Cloud
About the role
- Accountable for the installation, change management and oversight of Medicare, Medicaid and Exchange operations using research, analysis, testing and validation as tools.
- Own and manage the end-to-end Medicare Prescription Payment Plan (MPPP) program, collaborating with internal stakeholders and Medicare clients to meet business goals and regulatory requirements.
- Collaborate with implementation and project managers on the implementation and onboarding of Medicare Prescription Payment Plan (MPPP) clients, ensuring alignment with contract terms and CMS guidelines.
- Lead the interpretation and operational implementation of regulatory & sub-regulatory guidance, coordinating tasks & workplans across impacted operational departments.
- Develop and manage all MPPP documents, policies and procedures, reporting, project plans, job aids, workflows, etc.
- Serve as the primary point of contact for internal and external stakeholders regarding MPPP operations.
- Monitor internal operations and lead resolution of identified errors, including root cause analysis and implementation of corrective actions.
- Coordinate cross-functional teams to support execution and oversight of MPPP activities.
- Identify opportunities for improvement and participate in development of new solutions/capabilities for government program compliance and audit readiness.
- Ensure adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.
Requirements
- 5+ years of relevant PBM and/or Health Plan experience supporting Medicare Part D
- Experience with CMS Medicare Prescription Payment Plan operational and regulatory requirements
- Thorough knowledge of Medicare regulatory requirements and associated product and/or operational workflows
- Advance process and project management skills and corresponding toolsets (i.e. Jira, Confluence, Scribe, Lucid, etc.)
- MS Excel Skills – ability to create/maintain pivot table, forms, and formula’s (i.e. vlookup, true, if, left, etc)
- Ability to balance multiple complex projects simultaneously
- Extremely flexible, highly organized, and able to shift priorities easily
- Attention to detail & commitment to delivering high quality work product
- Excellent written and verbal communication skills
