Job Details

Job Location: Remote - Remote Employees, VA

Position Type: Full Time

Salary Range: $150000.00 - $150000.00

Job Shift: Day

About the Role

Capitol Bridge is seeking an experienced Program Manager to lead a complex, high-volume federal healthcare program supporting the Centers for Medicare & Medicaid Services (CMS). This role is responsible for the overall health, performance, compliance, and continued development of the program. The Program Manager will work closely with the project manager for each operational lane, all support leaders, cross-functional teams, external partners, and clients to ensure the program operates as one connected system.

We are looking for a leader who understands how to operate in a federal environment, translate regulatory and contractual requirements into execution, and lead teams through complexity and change. This person must be equally comfortable looking at the big picture and getting close enough to the work to understand where processes, systems, or teams are breaking down.

Direct experience with the No Surprises Act (NSA) and the Federal Independent Dispute Resolution (IDR) process is preferred. Experience with arbitration, healthcare appeals, claims, or payment disputes is also valuable. Strong CMS, federal healthcare, or comparable federal program experience remains important, and the right leader will be expected to learn the program deeply and quickly. This is a hands-on leadership role for someone who can build and maintain operational excellence while stabilizing, improving, and leading the program.

Key Responsibilities

Program Leadership & Operations

• Own performance and execution across all operational workstreams.
• Operate at a fast pace and deliver accurate, high-quality work within short turnaround times.
• Work directly in the details when needed rather than relying solely on delegation.
• Maintain clear trackers for priorities, deliverables, risks, decisions, dependencies, and follow-up actions.
• Drive assigned work from intake through completion, ensuring commitments do not stall or require repeated follow-up.
• Lead high-volume, deadline-driven operations under strict federal, contractual, quality, and service requirements.
• Translate contract requirements, CMS guidance, regulatory changes, and executive direction into operational plans.
• Set priorities, decision rights, accountability, and leadership operating rhythms.
• Monitor volume, inventory, aging, throughput, capacity, productivity, quality, and risk.
• Identify gaps and drive corrective actions through implementation.
• Build scalable processes that adapt to changing volume, regulations, and program needs.
• Maintain operational continuity and leadership coverage across critical functions.

CMS & Federal Program Management

• Serve as a senior program contact for CMS and other external stakeholders.
• Manage federal deliverables, performance standards, reporting, and contractual obligations.
• Evaluate, operationalize, document, train, implement, and monitor federal policy changes.
• Support client reviews, audits, readiness activities, corrective actions, and federal oversight.
• Identify and escalate risks before they become client or compliance concerns.
• Assign, track, complete, and validate client commitments.

Cross-Functional Integration

• Lead an integrated operating model by partnering with the project manager for each lane, all support leaders, cross-functional teams, partners, and clients across:
• Operations and production
• Quality assurance and peer review
• Training and instructional design
• Compliance and regulatory implementation
• Reporting and analytics
• Technology and system enhancements
• Customer support and escalations
• Billing and finance
• Workforce planning and staffing
• Vendors, consultants, and strategic partners
• Ensure these groups do not operate in silos by maintaining shared priorities, clear ownership, coordinated tracking, timely follow-up, and visibility into downstream impacts across the program.

Quality, Compliance & Regulatory Change

• Partner with Compliance, Quality, Training, and Operations to execute approved policies consistently.
• Translate regulatory and policy changes into operational requirements.
• Convert quality findings, audits, escalations, and recurring defects into corrective action.
• Maintain controls, documentation, version management, and implementation evidence.
• Embed quality and compliance into daily operations.

Data, Reporting & Systems

• Use data to assess performance, identify trends, anticipate risk, and guide decisions.
• Maintain reliable reporting on volume, aging, productivity, quality, timeliness, outcomes, backlog, escalations, and KPIs.
• Improve data integrity and reconciliation across internal and external systems.
• Hold operational leaders accountable for their metrics and results.
• Prioritize system enhancements based on operational and regulatory needs.
• Assign clear ownership for system issues, enhancements, UAT, defects, and implementation.

Partner & Stakeholder Management

• Build effective relationships with CMS, consultants, technology partners, vendors, and other stakeholders.
• Establish governance, meeting cadences, escalation paths, SLAs/KPIs, and ownership.
• Hold partners accountable while sustaining collaborative relationships.
• Communicate status, risks, decisions, dependencies, and needs to executive leadership.
• Balance competing internal, partner, and federal priorities while maintaining momentum.

Leadership & Team Development

• Lead and develop managers and program leaders.
• Set clear expectations and accountability within a sustainable operating environment.
• Coach leaders to decide, communicate, manage performance, and escalate effectively.
• Build organizational depth and reduce reliance on individuals or institutional knowledge.
• Ensure teams understand what is changing, why, and what is expected.
• Lead calmly through ambiguity, pressure, regulatory change, and competing priorities.

Qualifications

Required Qualifications

• Bachelor’s degree or equivalent education and relevant experience.
• 7+ years of progressive program or operations leadership overseeing complex, cross-functional programs.
• Substantial experience in federal programs, federal healthcare, or government contracting.
• Experience with CMS, HHS, Medicare, Medicaid, federal healthcare contractors, or comparable regulated programs strongly desired.
• Experience managing contractual deliverables, SLAs, KPIs, compliance, audits, and client oversight.
• Experience leading cross-functional operations, quality, training, compliance, reporting, technology, and vendor teams.
• Strong knowledge of governance, risk management, corrective action, performance management, and change implementation.
• Ability to use operational data to prioritize issues and drive measurable improvement.
• Experience managing vendors, consultants, technology partners, or subcontractors.
• Strong executive communication across federal clients, executives, leaders, and frontline teams.
• Ability to lead through complexity, rapid change, and competing priorities.

Preferred Qualifications

• Experience supporting CMS-administered programs.
• Experience with the No Surprises Act, Federal IDR process, IDRE operations, healthcare appeals, claims, payment disputes, or arbitration.
• Experience in a CMS or federal contractor, healthcare administrator, claims or appeals organization, or similarly regulated environment.
• Experience leading stabilization, transformation, corrective action, rapid growth, or regulatory change.
• Experience implementing operating models, governance, scorecards, quality programs, or technology-enabled improvements.
• PMP, PgMP, Lean Six Sigma, or comparable certification preferred.

What Success Looks Like

First 30 Days

The Program Manager will develop a strong understanding of the contract, CMS requirements, regulatory environment, operating model, leadership structure, systems, partners, and current program risks. They will assess program performance across operations, staffing, quality, training, compliance, reporting, technology, and partner management; establish relationships with key internal and external stakeholders; and identify immediate risks requiring stabilization.

First 60 Days

The Program Manager will establish clear operating rhythms, accountability, performance visibility, and escalation paths across the program. They will begin closing identified operational gaps, strengthen coordination between Operations, Quality, Training, Compliance, Reporting, and technology teams, and ensure regulatory and client requirements have clear paths from identification through implementation.

By 90 Days

The Program Manager will have clear ownership of the program and its operating model. Leadership should have reliable visibility into program health, performance, risks, and priorities. Teams should understand expectations and decision rights. Key partners should be operating within established governance. Regulatory and operational changes should move through a repeatable implementation process, and measurable progress should be visible across quality, timeliness, backlog, data integrity, leadership effectiveness, and overall program stability.

The Leader We Are Looking For

This program has a lot of moving pieces. We are not looking for someone who needs everything to be fully defined before they can lead. We need a builder and operator, someone who can understand a complex system, create structure where it is needed, develop strong leaders, and continue moving the program forward while improvements are underway. The right person sees beyond their individual lane. They understand how people, process, technology, compliance, data, client expectations, and culture affect one another. They can hold people accountable without creating unnecessary fear. They communicate early and often. They know when to get into the details and when to empower their leaders to own them. They can manage difficult conversations, competing priorities, and federal change without creating chaos for the team. Most importantly, they understand that running a successful federal program is not simply about hitting today's numbers. It is about building an operating environment capable of delivering consistent, compliant, defensible, and sustainable results over time.

Reasonable Accommodation

If you require alternative methods of application or screening, you must approach the employer directly to request this. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned.

EEO Statement

Capitol Bridge LLC is an Equal Opportunity Employer. All employment decisions at Capitol Bridge LLC are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate.

Texting Notice

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