Program Manager, Consultant - Group Medicare

Your Role

The Medicare team serves members across the state of California, including a Group Medicare offering for clients looking to provide a Medicare solution to their retiring employees and dependents. The Program Manager, Consultant will report to the Director of Group Medicare. In this role you will lead matrix relationships within Blue Shield related to Group Medicare accounts to build infrastructure around the PPO product, including capabilities around member engagement, operations, and utilization management. Responsibilities also include leading governance process and ongoing oversight of Group Medicare capabilities and overseeing workstreams and deliverables to ensure Blue Shield delivers on Group Medicare quality, membership, and OI outcomes.

Your Work and Experience

• Requires a bachelor’s degree or equivalent experience
• Requires at least 7 years of prior relevant experience, including direct work with Group Medicare Advantage products
• Requires experience managing or working with Group Medicare accounts and/or Account Management for Group Medicare accounts
• Requires deep understanding of CMS compliance requirements and Group Medicare regulations
• Requires exceptional presentation and communication skills addressing both client and retirees
• Demonstrated ability to work cross-functionally, influencing without direct authority
• Ability to identify and propose innovative solutions to meet the needs of clients and retirees

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