Government Program Operations Manager
New
J
Judi HealthHealth technology
Remote (For Non-Local) or Hybrid (Local to Denver or NYC area)Full-TimeManager
Salary115,600 - 182,500 USD per year
Apply NowOpens the employer's application page
Job Details
- Experience
- 5+ years
- Required Skills
- PythonSQLData AnalysisProcess improvementR
Requirements
- 5+ years of healthcare data experience
- 5+ years of relevant PBM and/or Health Plan experience supporting Medicare Part D, Medicaid, or Exchange plans
- 5+ years of experience working with SQL, R, or Python
- Experience working with cross-functional teams
- Ability to balance multiple complex projects simultaneously
- Extremely flexible, highly organized, and able to shift priorities easily
- Attention to detail and commitment to high quality work product
- Excellent written and verbal communication skills
- Ability to foster a culture of collaboration and high performing team
Responsibilities
- Interpret and operationalize CMS/state regulatory and sub-regulatory guidance
- Oversee timely implementation of regulatory changes
- Monitor internal operations, perform root cause analysis, and implement corrective actions
- Support claims correction activities (retro-eligibility and COB)
- Support internal, client, and government audits
- Drive team documentation of policies, procedures, workflows, and reporting
- Lead development of automated tools and scalable solutions
- Analyze complex encounter and PDE data to identify trends and improvement opportunities
- Define and document business/reporting requirements for system enhancements
- Track performance metrics for encounter and PDE submissions
View Full Description & ApplyYou'll be redirected to the employer's site
