Clinical Program Manager – CMS Medical Review

At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service provider—we're your trusted partner in innovation.

Location: Remote (U.S.)

Schedule: Monday–Friday, 8:00 AM–4:30 PM ET

Employment Type: Full-Time

We are seeking an experienced Program Manager to oversee daily operations for the CMS Review and Validation Contractor (RVC) Program. This role serves as the primary point of contact to the CMS RVC COR and is responsible for ensuring all contract, operational, and medical review requirements are executed in accordance with CMS guidelines.

The ideal candidate brings a strong clinical background (RN), extensive Medicare program knowledge, and proven leadership experience managing large, complex healthcare projects.

• Serve as the contractor's authorized representative on all daily operational matters.
• Maintain ongoing communication with the CMS RVC COR regarding contract performance, staffing, and deliverables.
• Oversee medical review activities and ensure compliance with CMS guidelines and FFS RAC Program requirements.
• Lead cross-functional teams and manage staff required to support RVC operations.
• Ensure accurate interpretation of Medicare coverage, documentation, and regulatory standards.
• Monitor project progress, performance measures, and quality assurance outputs.
• Prepare operational updates, reports, and data summaries for CMS and internal leadership.
• Ensure effective workflows, staffing coverage, and adherence to deadlines and contract terms.
• Provide clinical oversight and guidance across medical review tasks and methodologies.

• 5+ years of Program Management experience overseeing large or complex healthcare projects.
• Experience in medical review, healthcare auditing, or clinical review operations.
• Extensive knowledge of the Medicare program, including CMS regulatory and operational requirements.
• Working knowledge of the CMS FFS RAC Program.
• Strong leadership abilities with experience managing multidisciplinary teams.

• Master's degree in Business, Healthcare Administration, Nursing, Management, or a related healthcare field from an accredited institution.
• Current, active U.S. Nursing License (RN); must be maintained throughout employment.

• Excellent written and verbal communication skills.
• Strong analytical, organizational, and problem-solving abilities.
• Experience working with government contracts or federal healthcare programs.
• Ability to manage multiple projects and deadlines in a fast-paced environment.

• Opportunity to lead mission-critical work that supports the integrity of the Medicare program.
• Collaborative team environment with impactful clinical and operational responsibilities.
• Competitive compensation and benefits package.

Submit your resume detailing your program management experience, clinical background, and Medicare/CMS expertise.

What to Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and discuss salary requirements. Management will be conducting interviews with the most qualified candidates. We perform a background and drug test prior to the start of every new hires' employment. In addition, some positions may also require fingerprinting.

Broadway Ventures is an equal-opportunity employer and a VEVRAA Federal Contractor committed to providing a workplace free from harassment and discrimination. We celebrate the unique differences of our employees because they drive curiosity, innovation, and the success of our business. We do not discriminate based on military status, race, religion, color, national origin, gender, age, marital status, veteran status, disability, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities.