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CenCal Health · 8 hours ago

Medicare Program Manager

Santa Barbara, CA

Full-time

Onsite

Senior Level, Lead/Staff

$121K/yr - $181K/yr

10+ years exp

CenCal Health is a healthcare organization focused on providing essential support for their Medicare program. The Medicare Program Manager will lead and coordinate cross-functional operational initiatives to enhance the effectiveness and compliance of CenCal Health's Dual Eligible Special Needs Plan (D-SNP).

Non ProfitHealthcareProperty & Casualty InsuranceHealth CareInsurance

Responsibilities

Lead and support the operational execution of CenCal Health CareConnect’s D-SNP Medicare program by coordinating cross-functional initiatives that advance program viability, performance, and strategic goals

Serve as the central operational point of contact for Medicare governance bodies and D-SNP workgroups, including planning, facilitating, and supporting recurring meetings (e.g., Operations Meetings, Steering Committee) and ad hoc cross-functional forums

Drive Medicare program activities by managing workplans, tracking milestones and deliverables, identifying and mitigating risks, and ensuring timely execution across the Medicare line of business

Support ongoing program improvements by identifying operational gaps, facilitating solutions across departments, and promoting best practices that strengthen Medicare program effectiveness and compliance

Assist the Medicare Director in annual Medicare bid development in collaboration with Actuarial, Finance, and Product teams

Support the management and implementation of supplemental benefits, ensuring alignment with operational readiness and member communications

Assist the Medicare Director in the development and refinement of D-SNP workflows and operational processes

Support continuous improvement and compliance initiatives related to the Medicare product, including regulatory updates, policy changes, and operational enhancements

Obtain senior management approval for the D-SNP product by presenting the product charter, including high-level costs and benefits

Serve as the operational program manager for Medicare governance bodies, including D-SNP Operations Meetings, Governance Committee, and focused workgroups

Develop agendas, compile background materials, and track follow-up items to support effective governance meetings and decision-making

Monitor progress on governance action items and ensure accountability across departments

Establish alliances with departments and organizations by identifying dependencies and securing partnership commitments

Facilitate cross-functional collaboration to ensure clear communication, aligned responsibilities, and timely issue resolution

Manage relationships with project sponsors and team members through meetings and status updates

Manage multiple concurrent Medicare initiatives to ensure successful execution, on-time delivery, and scope alignment

Develop, maintain, and track operational workplans, timelines, action items, risks, and deliverables across Medicare workstreams

Prepare program status updates, dashboards, and presentations for leadership, steering committees, and internal partners

Collaborate with the Enterprise Project Management Office using standardized project management tools and templates; assist and educate department leads on project management practices

In collaboration with Operational Excellence, model and implement project management methodologies across the project lifecycle

Support development and maintenance of Standard Operating Procedures (SOPs) and Policies & Procedures (P&Ps)

Maintain governance documentation and records to support audits, regulatory reviews, and internal oversight

Assist with data gathering, analysis, and reporting for CMS, State, and internal requirements

Support development and maintenance of program dashboards and performance reports

Monitor CMS guidance and HPMS memos and track operational impacts

Perform other duties as assigned in support of Medicare product operations and organizational priorities

Qualification

Medicare program managementProject Management Professional (PMP)Program Management Professional (PgMP)Microsoft Office proficiencyProject management methodologiesAnalytical skillsCommunication skillsInterpersonal skillsOrganizational skillsProblem-solving skills

Required

Strong verbal and written communication skills with the ability to clearly convey information and ideas to diverse audiences

Demonstrated ability to prioritize competing demands, manage resources effectively, and adapt to evolving business needs

Proven ability to build and maintain constructive, collaborative working relationships across all levels of the organization

Experience representing the organization and providing information to internal and external stakeholders, including customers, regulatory entities, and business partners

Demonstrates high ethical standards, integrity, and alignment with organizational values; inspires trust and credibility

Supports team development by recognizing contributions, fostering collaboration, and promoting a positive, respectful work environment

Experience managing complex, multi-faceted projects, including both short- and long-term initiatives with varying team sizes

Strong interpersonal and facilitation skills, including the ability to lead meetings, resolve issues, and influence outcomes through problem-solving and persuasion

Ability to motivate and lead participants at all organizational levels without direct authority

Working knowledge of project management methodologies, tools, and best practices

Self-motivated with the ability to exercise sound independent judgment and decision-making

Demonstrated ability to work cooperatively to set goals, resolve problems, and make decisions that enhance organizational effectiveness

Excellent organizational and time management skills, with a proven ability to manage multiple projects concurrently

Strong analytical and critical thinking skills, with the ability to identify risks, develop solutions, and mitigate potential issues

Ability to effectively manage and support organizational change

Proficient decision-making, problem-solving, listening, and independent thinking skills

Proficiency in Microsoft Office applications and experience using project planning and tracking software

Knowledge of and experience with the software development life cycle (SDLC)

Bachelor's degree (or equivalent) in business, healthcare, technology, or a related field; an equivalent combination of education and relevant experience may be considered

Ten (10) or more years of related experience managing complex projects and/or programs

Project Management Professional (PMP®) certification required