Government Program Operations Manager – Analysis & Efficiencies
About the role
Position Summary
The Government Programs Operations Manager is responsible for overseeing the implementation, compliance, and optimization of Medicare, Medicaid, and Exchange programs. This position blends regulatory expertise with operational innovation to ensure that government program operations are both compliant and technically efficient.
This manager will lead a team dedicated to identifying, developing, and maintaining technical analysis and efficiencies across the department. Responsibilities include designing automated solutions, validating the accuracy of outgoing deliverables, and establishing scalable processes that support regulatory and business objectives. The role also involves interpreting CMS and state guidance, collaborating with internal subject matter experts and clients, and ensuring that system capabilities align with both regulatory intent and client needs.
In addition, the manager drives data-informed decision-making by overseeing the analysis of complex datasets to identify trends, outliers, and opportunities for process improvement. This includes creating detailed specifications for reports and operational tools and working closely with cross-functional teams—such as compliance, product, sales, marketing, underwriting, implementation, client services, and clinical operations—to enhance and maintain operational capabilities.
Position Responsibilities
- Interpret and operationalize CMS/state regulatory and sub-regulatory guidance in collaboration with Compliance and internal SMEs
- Oversee timely implementation of regulatory changes, coordinating cross-functional workplans across impacted departments