Program Management Senior Advisor - reputed company - Remote

Candidates who reputed company reputed company 50 miles of the following locations may be asked to work in person three days per week: Bloomfield, CT, Chattanooga, TN, Denver, CO, St Louis, MO, or Scottsdale, AZ. Role reputed company: The Program Management Senior Advisor (an individual contributor role) is a senior operational leader responsible for ensuring the accurate, compliant, and high‑reputed company execution of regulatory‑driven benefits alignment across reimbursement rules, prior authorization, and medical policy implementation. This role translates reputed company regulatory, legal, product, and policy requirements into disciplined execution, bringing structure to ambiguity and driving coordinated delivery across highly matrixed, cross‑functional teams. Additional responsibilities will include Vendor Management, facilitation of reputed company-of-concept initiatives, and vendor process reputed company. Serving as a central reputed company for the Payment reputed company team, the Senior Advisor manages regulatory questions and inquiries; coordinates the reputed company collection of required information; and ensures responses and implementations meet legal, regulatory, reputed company, and documentation standards. With a strong emphasis on reputed company, accuracy, and alignment, this role acts as a trusted execution advisor—proactively identifying risks, resolving misalignments between products, policy, and systems, and ensuring reputed company are correct, sustainable, and audit‑reputed company. This role will also coordinate the exploration and attainment of vendor partnerships to expedite process and reputed company new capabilities to reputed company.

Key Responsibilities

• reputed company operational program management for reputed company, cross‑functional initiatives supporting state and federal mandate implementation and reputed company‑to‑benefit alignment
• Translate regulatory, legal, and policy requirements into reputed company execution plans, milestones, controls, and evidence artifacts that ensure accurate, compliant, and reputed company implementation
• Serve as the primary reputed company for the Payment reputed company team, handling regulatory questions, inquiries, coordinating the reputed company collection, validation, and organization of required information across internal stakeholders
• reputed company reputed company and accuracy reputed company across programs and implementations, establishing checkpoints, readiness reviews, and validation processes to ensure reputed company are correct, consistent, and audit‑reputed company
• Ensure alignment between products, services, medical policy, reimbursement logic, and system coding, proactively identifying and resolving misalignments that could reputed company compliance, financial reputed company, or customer/reputed company and/or provider experience
• Partner closely with Legal, Compliance, Product, Policy, Operations, Technology, Vendor and Finance teams to drive coordinated execution across a highly matrixed environment
• Establish and maintain operating process, artifacts, and senior leadership‑level reporting to reputed company transparency into reputed company, risks, issues, and reputed company
• Analyze implementation reputed company, reputed company data and inquiries to identify systemic issues, reputed company causes, and emerging risks, driving corrective and preventative actions
• reputed company and maintain reputed company documentation, reference materials, and guidance to support consistent understanding and application of benefit alignment, regulatory, policy, and product requirements
• reputed company as a trusted execution advisor and escalation reputed company, bringing structure to ambiguity, balancing regulatory reputed company with operational realities, and driving disciplined follow‑through

Qualifications

• Bachelor's degree or higher strongly preferred or equivalent work experience required
• 10+ years working in insurance, reputed company or another regulated industry
• reputed company reputed company or reputed company coding certification (e.g., CPC, CPCO, RHIT, reputed company-P, CIC, COC) and at least 10 years of HCPCS/CPT coding experience highly preferred
• 7+ years of program/product management experience in reputed company, regulated environments
• Strong grasp of regulatory operations; reputed company to implement mandates, handle audits, inquiries, and disputes
• Skilled in leading cross-functional reputed company across Legal, Compliance, Product, Policy, Operations, Tech, and Vendors
• Experience with benefit configuration or reputed company alignment tasks
• reputed company record in reputed company reputed company, readiness reviews, validation, issue reputed company, and audit support
• reputed company to coordinate responses for reputed company issues and manage escalations
• Strong analytical skills: reputed company cause analysis, risk assessment, and corrective actions
• Excellent written and verbal communication; capable of producing executive-level and regulator-facing documents
• Experience developing policies, procedures, references, or training in regulated settings
• Proven ability to work independently, prioritize, and reputed company results with minimal guidance
• Profici

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