Program Manager

This is a fully remote position, open to applicants in Virginia.

📋 Description

• Oversee the overall health, performance, compliance, and ongoing development of a complex, high-volume federal healthcare program in support of CMS.

• Take ownership of performance and execution across all operational workstreams.

• Work at a swift pace to deliver precise, high-quality results within tight deadlines.

• Maintain trackers for priorities, deliverables, risks, decisions, dependencies, and follow-up actions.

• Lead high-volume, deadline-sensitive operations adhering to stringent federal, contractual, quality, and service standards.

• Convert contract requirements, CMS guidance, regulatory changes, and executive directives into operational plans.

• Monitor volume, inventory, aging, throughput, capacity, productivity, quality, and risk.

• Develop scalable processes and ensure operational continuity across essential functions.

• Act as a senior program contact for CMS and other external stakeholders.

• Manage federal deliverables, performance standards, reporting, and contractual obligations.

• Evaluate, document, train, implement, and monitor federal policy changes.

• Support client reviews, audits, readiness activities, corrective actions, and federal oversight.

• Facilitate integrated collaboration across operations, quality assurance, training, compliance, reporting, technology, customer support, billing, workforce planning, vendors, and partners.

• Transform quality findings, audits, escalations, and recurring defects into corrective actions.

• Maintain controls, documentation, version management, and implementation evidence.

• Utilize data to assess performance, identify trends, anticipate risks, and guide decision-making.

• Maintain reporting on volume, aging, productivity, quality, timeliness, outcomes, backlog, escalations, and KPIs.

• Prioritize system enhancements and assign ownership for system issues, UAT, defects, and implementation.

• Establish governance structures, meeting schedules, escalation pathways, SLAs/KPIs, and ownership.

• Communicate status updates, risks, decisions, dependencies, and needs to executive leadership.

• Lead and develop managers and program leaders.

• Establish operating rhythms, accountability, performance visibility, and escalation pathways during the initial 90 days.

• Build organizational depth and lead through uncertainty, pressure, regulatory changes, and competing priorities.

⛳️ Requirements

• Bachelor's degree or equivalent education and relevant experience.

• 7+ years of progressively responsible program or operations leadership overseeing complex, cross-functional programs.

• Significant experience in federal programs, federal healthcare, or government contracting.

• Experience with CMS, HHS, Medicare, Medicaid, federal healthcare contractors, or similar regulated programs is strongly preferred.

• Proven track record in managing contractual deliverables, SLAs, KPIs, compliance, audits, and client oversight.

• Experience in leading cross-functional operations, quality, training, compliance, reporting, technology, and vendor teams.

• Strong understanding of governance, risk management, corrective action, performance management, and change implementation.

• Ability to leverage operational data to prioritize issues and drive measurable improvements.

• Experience managing vendors, consultants, technology partners, or subcontractors.

• Excellent executive communication skills across federal clients, executives, leaders, and frontline teams.

• Capability to lead through complexity, rapid changes, and competing priorities.

• Experience supporting CMS-administered programs is preferred.

• Familiarity with the No Surprises Act, Federal IDR process, IDRE operations, healthcare appeals, claims, payment disputes, or arbitration is preferred.

• Experience working in a CMS or federal contractor environment, healthcare administration, claims or appeals organization, or similarly regulated context is preferred.

• Experience leading stabilization, transformation, corrective action, rapid growth, or regulatory change is preferred.

• Background in implementing operating models, governance, scorecards, quality programs, or technology-enabled improvements is preferred.

• PMP, PgMP, Lean Six Sigma, or a comparable certification is preferred.

🏝️ Benefits

• Comprehensive health insurance plans.

• Competitive salary and performance bonuses.

• Opportunities for professional development and career advancement.

• Flexible work arrangements and a supportive work environment.