Government Program Operations Specialist

Location: Remote (For Non-Local) or Hybrid (Local to Denver or NYC area)

Position Summary:

TheGovernment Programs Operations Specialist is a hands-on position responsible forcoordinatingthe day-to-day operations and activitiesof the Government Programs Operationsteam. This position providesthe candidateacareer growthopportunitywhilelearning aboutMedicare Part D,Medicaidand Exchange business.

Position Responsibilities:

• Manage the Government Programs Operations team shared Outlook mailbox, including but not limited to timely, accurate and complete responses, and ensuring timeframes for deliverables.
• Lead and execute pharmacy outreach initiatives related to CMS disputes, ensuring compliance with regulatory requirements and internal Government Operations procedures while applying judgment in communication strategy and issue resolution
• Serve as a key contributor in the validation of system enhancements, including evaluating output data,identifyingdiscrepancies, and providing recommendations to improve system performance and data integrity.
• Design,maintain, and continuously improve structured documentation frameworks, including job aids, policies and procedures (P&Ps), standard operating procedures (SOPs), and training materials to support operational consistency and scalability.
• Develop andoptimizeinternal workflows and job aids, driving process standardization andidentifyingefficiency opportunities across Government Programs Operations.
• Oversee daily PDE reconciliation activities, analyzing trends,identifyingvariances, and proactively addressing discrepancies to ensure data accuracy and compliance.
• Manage and resolve escalations arising from claims monitoring activities by applying critical thinking, root cause analysis, and cross-functional collaboration.
• Support strategic Government Programs Operations initiatives, contributing insights, process improvements, and subject matterexpertiseas assigned.
• Plan, coordinate, andfacilitatecross-functional meetings to drive alignment, resolve issues, and advance operationalobjectives.
• Collaborate closely with Government Programs Operations team members and business partners to address operational needs, improve processes, and support broader organizational goals.

Required Qualifications:

• 3+ years of experience in an equivalent role
• High school diplomarequired
• Experience with Medicare Part D and/or Pharmacy Technician experiencepreferred
• Organizational skills and a very keen eye for detail and accuracy.
• Experience working in high-growth, startup environments - an advantage.
• A positive and upbeat attitude, and excellent interpersonal communication skills.
• A commitment to deliveringa high levelof customer service, both internally and externally.
• Flexibility to respond to a range of different work situations.
• An ability to work under pressure and juggle multiple priorities at any given time.
• An ability to work well independently and be an effective collaborator within and across teams.