[Remote] Regulatory Policy Consultant (Remote)

Note: The job is a remote job and is open to candidates in USA. CareFirst BlueCross BlueShield is seeking a Regulatory Policy Consultant to provide strategic and tactical planning related to legislative and regulatory matters. The role involves analyzing legislation, ensuring compliance, and collaborating with various departments to improve operational processes and project outcomes.

Responsibilities

• Analyzes legislation and regulations as it relates to CareFirst and creates high level compliance requirements
• Primary/dedicated Regulatory point of contact for Project Managers who implementation projects
• Takes a lead role in various department and divisional projects, to ensure compliance with project compliance requirements, providing input on work team participants, identification of business needs and development of solutions, training, collaboration and communication
• Present content, insights and guidance to Mandates and other CareFirst business areas, BCBSA and/or Blues Plans as needed for generating successful knowledge sharing and working relationships
• Collaborate with other CareFirst Divisions/Departments and functional areas to help with identification of workflow opportunities driven by projects, operational changes and/or external regulations
• Represent Mandates on Corporate and external facing workgroups, legislative, regulatory, and stakeholder bodies work groups, Americas Health Insurance Plans (AHIP), the arenaflex and arenaflex Association (BCBSA), as needed
• Identify opportunities to create more robust processes surrounding new mandate projects to improve the throughput of the department, streamline operations, improve project outcomes and increase strategic alignment of technical delivery with business operations
• Leverage strong business acumen to act as a subject matter expert on a variety of Mandate and cross departmental projects, adding strategic perspective to project and problem-solving efforts
• Support internal and external policy decisions by providing management with analysis and recommendations on the operational impacts to CareFirst from external mandates
• Support the efforts of the Mandates and ePMO team in the creation, quality assurance and refinement of Project Documentation and Status Reporting Skills
• Bachelor's Degree in Business, Finance or Technology fields
• 10 years' Healthcare operations and/or healthcare regulatory business background
• Project management of healthcare related projects may be substituted for some of the years of business experience
• Considerable judgment, tact, initiative, accuracy and integrity
• Excellent interpersonal skills with ability to build consensus and agreement and bring resolution to contentious issues and entrenched interests
• Superior analytical skills and understanding of where to find information germane to mandates
• Ability to research complex issues, interpret regulations and regulatory rules/guidance, and exhibit sound judgment in determining a recommendation or solution to a problem
• Skill in using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems
• Self-motivated with a commitment to teamwork
• Ability to recognize, analyze, and solve a variety of problems
• Ability to convey information in a clear, concise, and logical manner
• In-depth understanding of healthcare payor industry and operational processes and impacts of regulatory guidance
• Effective written and interpersonal communication skills
• Knowledge of state legislative and regulatory processes, public policy analysis
• Understanding of insurance products and regulatory environment
• Proven analytical and problem-solving skills to evaluate business processes and recommend effective solutions
• Experience in project management, business process analysis, workflow, and task analysis
• Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence
• Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging
• Advance degree or Certificate in Public Health, Public Policy, Business, Finance or IT fields; or 15+ years progressive healthcare operations and/or healthcare regulatory experience
• Experience and exposure to both IT and Business functions in a management position
• Strong experience in connecting strategic imperatives to tactical project delivery, in collaboration with senior business and IT executives Benefits
• Comprehensive benefits package
• Various incentive programs/plans
• 401k contribution programs/plans Company Overview
• CareFirst. It’s not just our name. It’s our promise. It was founded in 1934, and is headquartered in Baltimore, Maryland, USA, with a workforce of 5001-10000 employees. Its website is Apply tot his job

Apply tot his job Apply To this Job