Project Manager, Senior - Group Medicare (non-IT)

Blue Shield of California•Long Beach, CA

9d•Hybrid

About The Position

Your Role The Group Medicare team is responsible for Client & Stakeholder Management, Retiree & Member Support Operations, Project Management & Execution, Compliance, Quality, & CMS Readiness, Data, Reporting & Continuous Improvement. In this role, you will help drive the operational excellence and continuous improvement of our Group Medicare offerings. You will coordinate cross‑functional workstreams, streamline operational processes, and partner closely with internal teams and external employer groups to enhance efficiency and elevate the overall experience for clients and members. Your work will directly strengthen the performance of our Group Medicare business, support the retiree population we serve, and identify opportunities to improve how we deliver and sustain our programs. The Project Manager, Senior - Group Medicare (non-IT) will report to the Program Manager. The Group Medicare team serves retirees both inside and outside of California. We partner with employer groups and plan sponsors to offer Medicare Advantage and Medicare Part D solutions tailored to their retiring employees and eligible dependents. This role plays a key part in ensuring those clients—and their retirees—receive high‑quality support throughout the plan lifecycle. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Requirements

Requires a bachelor’s degree or equivalent experience
Requires at least 5 years of prior relevant experience
Requires experience with project management methodologies, tools, and best practice
Requires experience within healthcare, managed care, or health plan operations

Nice To Haves

Experience working on Group Medicare Advantage products strongly preferred
Lean Six Sigma Green Belt or Black Belt certification (or equivalent process improvement training) with demonstrated ability to apply structured problem-solving and process optimization techniques strongly preferred
Strong understanding of CMS requirements, compliance standards, and annual readiness cycles strongly preferred
Demonstrated success driving operational improvement efforts by leading cross‑functional teams and coordinating multiple stakeholder groups toward shared business outcomes

Responsibilities

Lead small‑scale, high‑impact operational initiatives involving multiple internal and external stakeholders to improve processes, enhance service delivery, and support business objectives
Oversee the planning, development, and implementation of operational workflows and cross‑functional business processes, ensuring teams collaborate effectively to deliver new or enhanced internal/external programs and services
Manage programs from initiation through execution, ensuring operational readiness, consistency, and adoption, while driving continuous improvement across all projects within the program portfolio
Coordinates interdepartmental activities to ensure operational projects stay on schedule and within budget, driving alignment across teams and maintaining momentum toward program goals
Builds and leads project teams by assigning responsibilities, monitoring progress, and providing day‑to‑day operational guidance, ensuring effective collaboration and successful delivery of business initiatives
Develop the program, integrated program plan, resource plan, contingency plan, and related project management artifacts
Evaluate trade-offs between program size and complexity, cost, urgency, risk, and stakeholder value
Validate financial forecasts and provide on-going reconciliation of resources and other related program expenditures
Partner with business sponsors to define success metrics and criteria
Assess and resolve all high priority program risks as they are encountered
Ensure all projects adhere to project methodology compliance standards set by the company
Serve as a subject matter expert to regularly brief key stakeholders on different aspects of assigned initiatives
Represent the program in various project governance and inter-departmental forums
Define and track program milestones while developing, maintaining, and reporting on an overall integrated delivery plan
Manage operational and client-facing activities for the Group Medicare retiree line of business, ensuring smooth execution of implementations, annual readiness cycles, and ongoing plan updates
Coordinate cross-functional teams to support accurate retiree enrollment processing, member communications, issue resolution, and alignment with CMS requirements
Monitor Group Medicare performance trends and escalations, partnering with internal teams to drive improvements in service, compliance, and overall retiree experience
Other duties as assigned