Senior Manager Government Program Operations (exchange)

Capitalrx

Remote
Base: $120,000 - $135,000 usd; bonus/equity: not s...
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Exchange regulatory requirements
Edge server operations
Cms submissions and compliance
** Capitalrx is seeking a Senior Manager for Government Program Operations, responsible for overseeing the implementation and compliance of regulatory requirements related to Exchange plans. This fully remote position requires extensive experience in Prescription Benefit Management and team leadership. **

Job Summary

  • The Senior Manager is responsible for leading the end‑to‑end implementation, governance, and change management of regulatory requirements for Exchange plans and EDGE Server operations.
  • This role oversees the delivery of CMS submissions, compliance activities, contract applications, and bid‑related client support, while also coordinating responses to federal and state regulatory audits.
  • The Senior Manager ensures all regulatory reporting obligations are met for Exchange clients by interpreting CMS and state guidance, partnering with internal subject matter experts and client teams, and translating requirements into operational processes.

Matching Summary

Match Score: 75

** Capitalrx is seeking a Senior Manager for Government Program Operations, responsible for overseeing the implementation and compliance of regulatory requirements related to Exchange plans. This fully remote position requires extensive experience in Prescription Benefit Management and team leadership. **

Salary

Base: $120,000 - $135,000 USD; Bonus/Equity: Not specified; Benefits: Not specified

Skills & Requirements

Must-have

  • Exchange regulatory requirements
  • EDGE Server operations
  • CMS submissions and compliance
  • Regulatory audit response
  • Pharmacy benefit management

Nice-to-have

  • High-performance culture
  • Cross-functional collaboration
  • Client relationship management
  • Process optimization

Key Requirements

  • 6+ years PBM/Health Plan experience supporting Exchange plans
  • 5+ years people management experience
  • Vast knowledge of Exchange regulatory requirements
  • Proven success managing multiple complex projects
  • Excellent written and verbal communication skills

Work Rights

Not specified

Tailored Resume

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