Job Description

Copper River Strategies is seeking an experienced Program Director (PD) to oversee contract operations and provide strategic leadership for a healthcare insurance program. The Program Director will be responsible for managing staffing, deliverables, quality assurance, risk mitigation, reporting, and stakeholder communication while ensuring successful contract performance and operational execution. The ideal candidate will bring extensive healthcare insurance experience, strong knowledge of Medicare Advantage, and proven leadership managing programs involving significant volumes of Protected Health Information (PHI).

This position is primarily remote; however, onsite presence at the Center for Medicare & Medicaid Services (CMS) in Baltimore, Maryland, may be required on an as-needed basis to support program requirements, stakeholder meetings, and other business needs.

Responsibilities (include but are not limited to):

• Oversee all contract operations and ensure successful execution of program requirements.
• Lead staffing, workforce planning, and personnel management activities.
• Manage the development, review, and timely delivery of contract deliverables.
• Establish and maintain quality assurance processes and performance standards.
• Identify, assess, and mitigate operational, compliance, and program risks.
• Develop and provide regular program status reports to leadership and stakeholders.
• Serve as a primary point of contact for Government and organizational stakeholders.
• Ensure appropriate handling, protection, and management of programs involving large volumes of Protected Health Information (PHI).
• Monitor operational performance and implement corrective actions when necessary.
• Coordinate cross-functional teams to ensure alignment with program objectives.
• Ensure compliance with applicable healthcare insurance and Medicare program requirements.
• Provide strategic leadership and operational oversight to support continuous program improvement.

Essential Job Qualifications and Requirements:

• Education:
  • Bachelor's or master's degree in Public Policy, Health, Business, or a related field from an accredited institution.
    • Minimum of five (5) years of management experience with a master's degree, OR seven (7) years of management experience with a bachelor's degree

• Required Experience:
  • Minimum of eight (8) years of experience in healthcare insurance, including Medicare, Medicaid, or private health insurance
  • Demonstrated experience managing operations involving significant amounts of Protected Health Information (PHI)

• Demonstrated Knowledge & Skills:
  • Strong knowledge of Medicare Advantage (Part C)
  • Strong leadership, organizational, analytical, and communication skills
  • Contract operations and deliverable management
  • Quality assurance and performance management
  • Risk mitigation and issue resolution
  • Staffing and workforce management
  • Program reporting and stakeholder communications
  • Strategic planning and operational process improvement