Government Program Operations Specialist (Medtech)

TL;DR

Government Program Operations Specialist (Medtech): Coordinating day-to-day operations for Government Programs (Medicare Part D, Medicaid, Exchange business) with an accent on regulatory compliance and operational efficiency. Focus on managing CMS disputes, optimizing internal workflows, and ensuring data integrity through PDE reconciliation and system validation.

Location: Must be based in the US. Remote (for non-local) or Hybrid (for those local to Denver or NYC area).

Salary: $69,200 – $109,000 USD (depending on location)

Company

Enterprise health technology company providing a comprehensive suite of solutions and a proprietary Enterprise Health Platform (EHP) to rebuild trust in U.S. healthcare.

What you will do

• Coordinate day-to-day operations and activities for the Government Programs Operations team.
• Lead pharmacy outreach initiatives related to CMS disputes, ensuring regulatory compliance.
• Validate system enhancements, analyze output data, and recommend performance improvements.
• Design and maintain structured documentation frameworks, including SOPs, job aids, and training materials.
• Oversee daily PDE reconciliation and resolve claims monitoring escalations using root cause analysis.
• Facilitate cross-functional meetings to drive alignment and advance operational objectives.

Requirements

• Must be based in the United States.
• 3+ years of experience in an equivalent operations role.
• High school diploma.
• Experience with Medicare Part D and/or Pharmacy Technician experience preferred.
• Strong organizational skills and high attention to detail.
• Ability to work under pressure and manage multiple competing priorities.

Nice to have

• Experience working in high-growth, startup environments.

Culture & Benefits

• Collaborative environment focusing on healthcare infrastructure innovation.
• Flexible work arrangements (Remote or Hybrid options).
• Opportunity for career growth within the Medicare, Medicaid, and Exchange business domains.
• commitment to diversity and equal employment opportunities.