Regulatory Operations Manager (Remote)CareFirst, Inc. • Baltimore, Maryland, United States
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Regulatory Operations Manager (Remote)
CareFirst, Inc.
- Baltimore, Maryland, United States
- Baltimore, Maryland, United States
À propos
Accountable for the tracking, analysis, and evaluation of new local, state, and federal regulations (Association mandates).
Maintains a comprehensive legislative tracker and monitors regulatory guidelines; determines if implementation is required and confirms compliance or informational distribution for mandates that impact CareFirst.
Tracks the achievement of CareFirst compliance status and timelines; coordinates with EPMO project teams for execution of mandate implementation projects.
Works with Legal, Business, and EPMO to ensure project implementation activities result in compliance with mandates that are operationally plausible.
Manages annual regulatory operations projects that lack a single business owner (e.g., MLR and Creditable Coverage Notification); develops, maintains, and oversees processes for tracking and reporting on these projects, ensuring timely and accurate completion.
Accountable for staffing activities, including recruitment, interviewing, selection, and hiring of qualified staff; provides oversight and direction to employees in line with organizational policies and procedures.
Responsible for coaching, mentoring, and developing staff, overseeing new employee onboarding, providing career development planning, and delegating as appropriate to direct reports.
Responsible for performance management and completion of annual performance evaluations; provides timely performance feedback through employee recognition, rewards, and disciplinary action; maintains transparent communication with employees via meetings, one‑on‑one discussions, and email, IM, and regular interpersonal communication.
Accountable for reporting and documentation; establishes and maintains auditable business processes for efficient data collection and submission to regulatory bodies; oversees creation and submission of annual and ad‑hoc reports, ensuring accurate and legally vetted data.
Responsible for cross‑departmental collaboration; works closely with PPGA, Legal, EPMO, Compliance, and other departments to establish and maintain effective processes for the handoff and execution of regulatory work; serves as a liaison to facilitate communication and collaboration.
Accountable for providing the VP of Regulatory Operations and other business areas with relevant information for strategic decision making by delivering analysis and subject‑matter expertise on mandates.
SUPERVISORY RESPONSIBILITIES This position manages people.
QUALIFICATIONS Education Level: A Bachelor's Degree in Business or a related field, or in lieu of a Bachelor's degree, an additional four years of relevant work experience plus the required work experience.
Experience: Five years in an IT and/or business role in a health insurance or regulatory compliance environment, with one year of supervisory or progressive leadership experience.
PREFERRED QUALIFICATIONS
Understanding of federal, state, and local legislative and regulatory processes and public policy analysis.
Comprehensive understanding of the healthcare payor industry, insurance products, and regulation.
Expansive knowledge of CareFirst operations.
KNOWLEDGE, SKILLS AND ABILITIES (KSAs)
Strong verbal and written communication, problem‑solving, negotiation, and decision‑making skills to influence management and partners.
Demonstrated leadership abilities and effectiveness in matrix management; strong management and team‑building skills.
Excellent business analysis and process improvement skills; ability to work well with all levels of management, including senior and executive levels.
COMPENSATION
Salary Range : $112,960 - $209,682
The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is performed. This compensation range is specific and considers factors such as the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business considerations. Compensation decisions depend on each situation’s facts and circumstances, including but not limited to experience, internal equity, and location. In addition to the base salary, CareFirst offers a comprehensive benefits package, incentive programs, and a 401(k) contribution plan (all benefits/incentives are subject to eligibility requirements).
LEGAL STATEMENTS Equal Employment Opportunity: CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. The Company provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Department: Corporate Governance
PHYSICAL DEMANDS The associate is primarily seated while performing duties. Occasional walking or standing is required. Hands are regularly used to write, type, key, and handle small controls. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
EMPLOYMENT REQUIREMENT Must be eligible to work in the United States without sponsorship.
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Compétences linguistiques
- English
Avis aux utilisateurs
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