[Remote] Program Manager - Federal Health (CMS)

Note: The job is a remote job and is open to candidates in USA. Commence is a company focused on data-driven transformation in healthcare. They are seeking a Program Manager to lead a CMS contract, ensuring contract performance, managing a multi-disciplinary team, and overseeing compliance with performance standards.

Responsibilities

• Serve as the single, accountable point of contact for CMS, including the Contracting Officer Representative (COR) and Contracting Officer (CO), on all contract matters
• Own all contractual delivery timelines, ensuring on-time submission of all deliverables, reports, and performance data required by the SOW
• Lead and manage a multi-disciplinary team including clinical reviewers, medical coders, customer service representatives, and IT staff; oversee hiring, training, performance management, and workforce planning
• Monitor and ensure compliance with all contractual performance standards (including timeliness, accuracy, and provider communication requirements); proactively identify and resolve operational issues before they escalate
• Oversee the development and submission of all required CMS reports, data deliverables, and program status updates in adherence to CMS reporting cadences
• Lead contract kickoff activities, transition planning, and ongoing relationship management with CMS stakeholders including the COR and CO
• Oversee Medicare Part A/B/DMEPOS claim review operations, including workflow design, case management systems, and quality assurance processes
• Manage subcontractor relationships and performance in alignment with prime contract requirements
• Champion a culture of compliance, accuracy, and continuous improvement across all program functions

Skills

• Minimum 5 years of professional experience in healthcare program management, federal contracting, or a related field
• Minimum 3 years of experience managing complex systems and workflows as a manager or supervisor
• Minimum 3 years of experience in Medicare Fee-for-Service (FFS) program operations
• Bachelor's degree required; Master's degree preferred. In lieu of a Master's degree, 4 additional years of relevant experience may be substituted
• Prior Project Manager or Program Director experience on a CMS medical review contract
• Operational familiarity with Medicare Part A, Part B, and DMEPOS claim review processes and adjudication workflows
• Demonstrated experience managing teams of 100 or more staff in a federal healthcare contractor environment
• Working knowledge of CMS reporting cadences, contract kickoff processes, and the COR/CO relationship structure in a federal contracting environment

Benefits

• This is a remote position.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Commence is an equal employment opportunity for employer.
• All personnel processes are merit-based and applied without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military and veteran status or any other characteristic protected by applicable law.
• Commence.AI is committed to providing equal employment opportunities to all applicants, including individuals with disabilities.
• If you require reasonable accommodation to participate in the application process due to a disability, please contact Human Resources at (757) 306-4920 or [email protected].

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