Government Program Operations Specialist in United States at Jobgether
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Job Description
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.
- 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.