Program Director

Accountabilities

• • Program leadership: Own overall program and contract performance, including strategy, execution, compliance, quality, resource allocation, and delivery across multiple workstreams and teams.
  • Operational oversight: Direct multidisciplinary functions including PMO, security, infrastructure, help desk, data, business analysis, testing, vendor management, and related operational activities.
  • Strategic planning: Develop forward-looking strategies, roadmaps, and operational improvements that strengthen program maturity, scalability, efficiency, and adaptability.
  • CMS partnership: Serve as the primary senior liaison with CMS, maintaining proactive communication, negotiating priorities, clarifying requirements, resolving issues, and anticipating stakeholder needs.
  • Financial and administrative management: Oversee budgets, funds, resource utilization, billing, collections, and other financial operations while ensuring appropriate controls and compliance.
  • People leadership: Supervise technical and administrative professionals, including subordinate managers, while establishing performance expectations, schedules, work standards, and accountability.
  • Vendor and subcontractor management: Monitor external partners, ensure quality and timely delivery, resolve issues, and maintain alignment with contractual and operational requirements.
  • Technology and data operations: Oversee activities involving Salesforce, AWS, secure data exchanges, integrations, analytics, and systems supporting healthcare program operations.
  • Program integrity and analytics: Strengthen data-driven capabilities, including risk identification and fraud, waste, and abuse detection, to improve program performance and mitigate emerging risks.
  • Continuous improvement: Advance automation, streamlined processes, scalable frameworks, and operational best practices across program functions.
  • Strategic advisory: Provide senior leadership with insights on policy developments, industry trends, competitive intelligence, resource requirements, risks, and strategic opportunities.
  • Cross-functional integration: Identify dependencies across initiatives, align program priorities with broader organizational objectives, and help optimize resource allocation and strategic execution.
  • Documentation and communications: Ensure comprehensive program documentation and oversee training, webinars, communications, outreach materials, metrics reporting, and help desk analytics.

  Requirements

  • Education and experience: Bachelor’s degree with 20+ years of senior management experience overseeing large-scale, multi-task programs or projects in regulated environments.
  • CMS expertise: 15+ years of experience working with CMS programs, ACA risk adjustment operations, RADV, audit processes, and complex multi-vendor ecosystems.
  • Technical proficiency: Advanced knowledge of Microsoft SQL Server, Python, Power BI, and Tableau, with the ability to leverage data and analytics for operational and strategic decision-making.
  • Leadership: Demonstrated experience managing technical and administrative teams, supervising managers, establishing standards, ensuring quality, and managing subcontractors.
  • Stakeholder management: Excellent written, verbal, presentation, listening, and facilitation skills, with a strong track record of working with senior leaders and complex stakeholder groups.
  • Strategic capability: Ability to translate policy, technology, workforce, and operational developments into practical strategies, measurable improvements, and long-term program plans.
  • Problem-solving: Strong analytical judgment and the ability to identify risks, resolve complex issues, manage competing priorities, and make decisions in high-visibility environments.
  • Public Trust: Ability to obtain the required Public Trust clearance.
  • Residency requirement: Must have lived in the United States for at least 3 of the past 5 years.
  • Preferred: Experience with Salesforce, AWS, and related technologies.
  • Preferred: PMP certification, including candidates currently working toward certification.
  • Preferred: Lean Six Sigma Green Belt certification, including candidates currently working toward certification.

  Benefits

  • Salary: Expected annual compensation range of $161,500–$218,500, with actual compensation determined by experience, geographic location, and applicable contractual requirements.
  • Work arrangement: Fully remote position with a standard 40-hour work week.
  • Travel: Less than 10% travel expected.
  • Healthcare: Multiple medical plan options, including plans with Health Savings Accounts, plus dental and vision coverage.
  • Retirement: 401(k) plan with employer matching and pre-tax/post-tax contribution options.
  • Paid time off: Vacation, sick, personal, and holiday leave, with typically 15 days of paid leave plus 10 paid holidays for new employees, prorated where applicable.
  • Family support: Paid parental and family leave, including up to 160 hours of paid family leave in a rolling 12-month period for eligible employees.
  • Additional protection: Short- and long-term disability, life insurance, accidental death and dismemberment, critical illness, personal accident, and business travel insurance options.
  • Career growth: Access to AI-powered career development resources, learning opportunities, and internal mobility support.
  • Culture: Supportive, innovation-focused environment with opportunities to work on high-impact government and healthcare programs.