Senior EPMO Project Manager (Medicare)

Blue Cross & Blue Shield of Rhode Island • Providence, RI

1d • Hybrid

About The Position

Please email [e-mail] if you are a candidate seeking a reasonable accommodation for the application and/or interview process. At BCBSRI, our greatest resource is our people. We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do—not just for our members, but for our employees as well. We recognize that to do your best work, you have to be your best self. It’s why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees. Our culture is one of belonging. We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you’re at in the organization, you’re an integral part of our team and your input, thoughts, and ideas are valued. Join others who value a workplace for all. We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders. We’re dedicated to serving Rhode Islanders. Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state—building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer. Why this job matters: Work within the Enterprise Program Management Office (EPMO) to execute medium to large scale IT and operational projects following defined standards and project governance structure. Plan and execute projects within the established scope, budget, and timeline. Lead cross-functional teams, ensuring effective communication with stakeholders, and overseeing the successful delivery of IT solutions. What you will do: Develop and execute comprehensive project plans inclusive of IT application updates and operational deliverables. Identify critical path, outlining tasks, timelines, and resource requirements. Engage and manage contracted deliverables with multiple suppliers and partners, ensuring timely delivery. Lead cross-functional teams, fostering a positive and collaborative team culture, promoting innovation and problem-solving. Communicate effectively with stakeholders to synthesize information, provide updates, and manage expectations. Interact with the business line and leadership, running Steering Committees and providing project updates. Monitor project progress, analyze data, and generate reports to track key performance indicators. Identify and mitigate project risks, making strategic decisions to keep projects on track. Utilize analytical skills to make critical decisions and recommendations to solve project-related problems. Allocate resources efficiently, balancing workload and ensuring team members have the necessary tools and support. Manage the project budget, including monthly forecasting, accruals, and proposed budget changes. Ensure compliance with organizational policies, procedures, and quality standards. Stay current with industry trends and technologies, applying relevant knowledge to enhance project outcomes. Perform other duties as assigned. Medicare‑Specific Experience & Responsibilities: Demonstrated experience managing Medicare Advantage (MA), PDP, or DSNP initiatives in a highly regulated environment. Working knowledge of CMS regulations and operational timelines, including: Annual Enrollment Period (AEP) Bid cycle and mid‑year regulatory changes CMS submission windows and enforcement deadlines Ability to partner effectively with Compliance, Legal, Regulatory Affairs, and Government Programs teams to ensure delivery aligns with CMS requirements. Accountable for end‑to-end delivery of Medicare initiatives with immovable CMS deadlines, proactively managing risks, dependencies, and trade‑offs to ensure regulatory commitments are met Experience overseeing Medicare‑specific data exchanges and integrations, including (but not limited to): Eligibility and enrollment files Claims and encounter data Pharmacy/PBM integrations CMS‑related reporting feeds Proven ability to manage multi‑vendor delivery models (e.g., core platform vendors, PBMs, analytics partners, CMS‑adjacent vendors). Maintains audit‑ready project artifacts and ensures traceability from regulatory requirements through implementation and delivery. Proven ability to communicate clearly with senior leadership on Medicare risks, regulatory impacts, and delivery trade‑offs. What you need to succeed: Knowledge of project management methodologies, processes, and tools Proficiency in Microsoft Project. Ability to facilitate meetings & teamwork, demonstrates leadership and problem-solving skills. Ability to collaborate while dealing with complex situations. Ability to motivate, lead and inspire a diverse group to a common goal/solution with multiple stakeholders. Advanced analytical skills, with the ability to interpret and synthesize complex data sets. Good business acumen and political savvy Knowledge of business process improvement techniques and strategies Excellent verbal and written communications skills Negotiation skills Presentation skills Problem solving and decision-making skills. Ability to interface with employees at all levels. Ability to effectively navigate ambiguous situations with limited direction. Excellent organizational skills and ability to successfully prioritize multiple priorities. Location: BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role: In-office: onsite 5 days per week Hybrid: onsite 2-4 days per week Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today’s healthcare industry. BCBSRI is an equal opportunity employer. The law requires an employer to post notices describing the Federal laws. Please visit www.eeoc.gov/know-your-rights-workplace-discrimination-illegal to view the "Know Your Rights" poster. Introduce yourself to our recruiters and we'll get in touch if there's a role that seems like a good match. At BCBSRI, our greatest resource is our people. We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do—not just for our members, but for our employees as well. We recognize that to do your best work, you have to be your best self. It’s why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees. Our culture is one of belonging. We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you’re at in the organization, you’re an integral part of our team and your input, thoughts, and ideas are valued. Join others who value a workplace for all. We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders. We’re dedicated to serving Rhode Islanders. Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state—building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer. Location: BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role: In-office: onsite 5 days per week Hybrid: onsite 2-4 days per week Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today’s healthcare industry. BCBSRI is an equal opportunity employer. The law requires an employer to post notices describing the Federal laws. Please visit www.eeoc.gov/know-your-rights-workplace-discrimination-illegal to view the "Know Your Rights" poster.

Requirements

• Knowledge of project management methodologies, processes, and tools
• Proficiency in Microsoft Project.
• Ability to facilitate meetings & teamwork, demonstrates leadership and problem-solving skills.
• Ability to collaborate while dealing with complex situations.
• Ability to motivate, lead and inspire a diverse group to a common goal/solution with multiple stakeholders.
• Advanced analytical skills, with the ability to interpret and synthesize complex data sets.
• Good business acumen and political savvy
• Knowledge of business process improvement techniques and strategies
• Excellent verbal and written communications skills
• Negotiation skills
• Presentation skills
• Problem solving and decision-making skills.
• Ability to interface with employees at all levels.
• Ability to effectively navigate ambiguous situations with limited direction.
• Excellent organizational skills and ability to successfully prioritize multiple priorities.
• Bachelor’s degree in Business Administration, Computer Science, or related field
• Five to seven years of project management experience with knowledge of Project Development Life Cycle and Software Development Life Cycle methodologies.
• Experience leading a team.
• Experience using the Microsoft Office Suites, including proficiency utilizing Microsoft Project.
• Experience in budgeting and financial management.

Nice To Haves

• Active PMP certification or other Project Management certification.
• Experience managing projects with multi-vendor and multi-application changes.

Responsibilities

• Develop and execute comprehensive project plans inclusive of IT application updates and operational deliverables.
• Identify critical path, outlining tasks, timelines, and resource requirements.
• Engage and manage contracted deliverables with multiple suppliers and partners, ensuring timely delivery.
• Lead cross-functional teams, fostering a positive and collaborative team culture, promoting innovation and problem-solving.
• Communicate effectively with stakeholders to synthesize information, provide updates, and manage expectations.
• Interact with the business line and leadership, running Steering Committees and providing project updates.
• Monitor project progress, analyze data, and generate reports to track key performance indicators.
• Identify and mitigate project risks, making strategic decisions to keep projects on track.
• Utilize analytical skills to make critical decisions and recommendations to solve project-related problems.
• Allocate resources efficiently, balancing workload and ensuring team members have the necessary tools and support.
• Manage the project budget, including monthly forecasting, accruals, and proposed budget changes.
• Ensure compliance with organizational policies, procedures, and quality standards.
• Stay current with industry trends and technologies, applying relevant knowledge to enhance project outcomes.
• Perform other duties as assigned.
• Demonstrated experience managing Medicare Advantage (MA), PDP, or DSNP initiatives in a highly regulated environment.
• Working knowledge of CMS regulations and operational timelines, including: Annual Enrollment Period (AEP) Bid cycle and mid‑year regulatory changes CMS submission windows and enforcement deadlines
• Ability to partner effectively with Compliance, Legal, Regulatory Affairs, and Government Programs teams to ensure delivery aligns with CMS requirements.
• Accountable for end‑to-end delivery of Medicare initiatives with immovable CMS deadlines, proactively managing risks, dependencies, and trade‑offs to ensure regulatory commitments are met
• Experience overseeing Medicare‑specific data exchanges and integrations, including (but not limited to): Eligibility and enrollment files Claims and encounter data Pharmacy/PBM integrations CMS‑related reporting feeds
• Proven ability to manage multi‑vendor delivery models (e.g., core platform vendors, PBMs, analytics partners, CMS‑adjacent vendors).
• Maintains audit‑ready project artifacts and ensures traceability from regulatory requirements through implementation and delivery.
• Proven ability to communicate clearly with senior leadership on Medicare risks, regulatory impacts, and delivery trade‑offs.

Benefits

• flexible work arrangements that include remote and hybrid opportunities and paid time off
• tuition reimbursement
• assist with student-loan repayment
• health, dental, and vision insurance as well as programs that support your mental health and well-being
• competitive pay
• bonuses and investment plans
• additional paid time to volunteer

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level