Government Program Operations Specialist

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Government Program Operations Specialist in United States.

This role is a key operational position within a healthcare-focused organization supporting government-sponsored programs, where you will help ensure the accuracy, compliance, and efficiency of critical pharmacy and claims-related workflows. You will be responsible for coordinating daily operational activities tied to Medicare Part D and other government programs, working at the intersection of data, process execution, and regulatory requirements. The role involves managing communications, resolving escalations, and maintaining high-quality documentation and operational standards across teams. You will also contribute to system improvements, workflow optimization, and cross-functional initiatives that enhance overall performance. This is a highly detail-oriented and fast-paced environment where accuracy and accountability are essential. You will collaborate closely with internal teams and external partners to support seamless execution of government program operations.

Accountabilities:

Manage daily operational workflows for Government Programs, including mailbox coordination, timely responses, and prioritization of deliverables.
Oversee PDE reconciliation activities, identifying trends, variances, and discrepancies to ensure data accuracy and compliance.
Lead pharmacy outreach initiatives related to CMS disputes, ensuring proper execution and adherence to regulatory requirements.
Support claims monitoring and escalation resolution by conducting root cause analysis and coordinating cross-functional responses.
Develop, maintain, and improve operational documentation, including SOPs, policies, job aids, and training materials.
Participate in validation of system enhancements by reviewing outputs, identifying issues, and recommending improvements.
Plan and facilitate cross-functional meetings to align stakeholders and drive resolution of operational priorities.

Requirements:

3+ years of experience in operations, healthcare, or a related field, with exposure to government programs preferred.
Familiarity with Medicare Part D, Medicaid, Exchange programs, or pharmacy/PBM operations is strongly preferred.
Strong attention to detail with excellent organizational and documentation skills.
Ability to manage multiple priorities in a fast-paced, high-volume operational environment.
Experience working with claims data, reconciliation processes, or healthcare operations workflows is an advantage.
Strong communication and interpersonal skills with a collaborative and service-oriented mindset.
Ability to work independently while effectively coordinating across teams and stakeholders.
High level of adaptability, problem-solving ability, and comfort working under pressure.

Benefits:

Competitive salary ranging from $69,200 to $109,000 USD depending on location and experience.
Remote or hybrid work flexibility depending on geographic location.
Comprehensive healthcare and employee benefits package.
Opportunity to gain deep expertise in Medicare Part D and government healthcare programs.
Exposure to high-impact healthcare operations within a fast-growing environment.
Career development opportunities in healthcare operations and program management.
Inclusive and equal opportunity workplace culture focused on collaboration and growth.

How Jobgether works:

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Why Apply Through Jobgether?

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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Government Program Operations Specialist

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