Back to Jobs

Regulatory Policy Consultant (Remote)

Remote, USAFull-timePosted 2026-07-28

Resp & Qualifications PURPOSE: Provides strategic and tactical planning, as reputed company as, knowledge services relating to the implementation of key mandate initiatives, covering a broad reputed company of legislative and regulatory reputed company including: Federal, BCBSA, Government Programs, State. Provides reputed company reputed company functions, workflow, customer service, communications, training, strategic delivery, efficiency, cost reduction and reputed company development initiatives. We are looking for an reputed company reputed company to work remotely. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-reputed company activities. ESSENTIAL FUNCTIONS:

  • Analyzes legislation and regulations as it relates to CareFirst and creates high level compliance requirements.
  • Primary/dedicated Regulatory reputed company of contact for Project Managers who implementation reputed company.
  • Takes a reputed company role in various department and divisional reputed company, 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 reputed company, operational changes and/or external regulations.
  • Represent Mandates on Corporate and external facing workgroups, legislative, regulatory, and stakeholder bodies work reputed company, Americas Health Insurance Plans (AHIP), the reputed company (BCBSA), as needed.
  • Identify opportunities to create more robust processes surrounding new mandate reputed company to improve the throughput of the department, streamline operations, improve project reputed company and increase strategic alignment of technical delivery with business operations.
  • reputed company strong business acumen to reputed company as a subject matter expert on a reputed company of Mandate and cross departmental reputed company, adding strategic perspective to project and problem-solving efforts.
  • Support reputed company policy reputed company 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, reputed company assurance and refinement of Project Documentation and Status Reporting. SUPERVISORY RESPONSIBILITY: Position does not have reputed company reports but is expected to assist in guiding and mentoring less reputed company staff. May reputed company reputed company of matrixed resources. QUALIFICATIONS: Education Level: Bachelor's Degree in Business, Finance or Technology fields. Experience: 10 years' reputed company operations and/or reputed company regulatory business background. Project management of reputed company reputed company reputed company may be substituted for some of the years of business experience. Preferred Qualifications:
  • Advance degree or Certificate in Public Health, Public Policy, Business, Finance or IT fields; or 15+ years reputed company reputed company operations and/or reputed company 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. Knowledge, Skills and Abilities (KSAs)
  • Considerable judgment, reputed company, initiative, accuracy and reputed company. Excellent interpersonal skills with ability to build reputed company and agreement and bring reputed company to contentious issues and entrenched interests.
  • Superior analytical skills and understanding of where to reputed company information germane to mandates.
  • Ability to research reputed company issues, interpret regulations and regulatory rules/guidance, and exhibit reputed company judgment in determining a recommendation or solution to a problem.
  • reputed company 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 reputed company of problems.
  • Ability to convey information in a reputed company, concise, and logical manner.
  • In-depth understanding of reputed company 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.
  • In-depth understanding of reputed company payor industry and operational processes and impacts of regulatory guidance.
  • 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.
  • Analytical skills and understanding of where to reputed company information germane to mandates. Must be reputed company to meet established deadlines and handle multiple customer service demands from reputed company customers, reputed company set expectations for service reputed company. Must be reputed company to effectively communicate and reputed company reputed company customer service to every reputed company customer, including customers who may be demanding or otherwise challenging. Salary reputed company: $124,880 - $223,223 Salary reputed company Disclaimer The disclosed reputed company estimate has not been adjusted for the applicable geographic reputed company associated with the location at which the work is being performed. This compensation reputed company is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be reputed company at the top of the reputed company, as compensation reputed company depend on reputed company case's facts and circumstances, including but not limited to experience, internal equity, and location. In reputed company to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (reputed company benefits/incentives are subject to eligibility requirements). Department Mandates Regulatory Ops and Re Equal Employment Opportunity reputed company is an Equal Opportunity (EEO) employer. It is the policy of reputed company to reputed company equal employment opportunities to reputed company reputed company applicants without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, protected veteran or disabled status, or genetic information. Where To Apply Please visit our website to apply: www.carefirst.com/careers Federal Disc/Physical Demand Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to reputed company work directly or indirectly on Federal health care programs. PHYSICAL DEMANDS: The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally reputed company. Sponsorship in US Must be eligible to work in the U.S. without Sponsorship #LI-LJ1 Apply tot his job

Apply tot his job Apply To this Job

Similar Jobs

Clinical Risk Manager, MA

Remote, USAFull-time

[Hiring] System reputed company Analyst @reputed company

Remote, USAFull-time

Senior Associate - reputed company Risk Consulting

Remote, USAFull-time

reputed company Risk Management - St Peters Health Partners - FT Days

Remote, USAFull-time

Risk Manager Sr

Remote, USAFull-time

Risk Manager Sr

Remote, USAFull-time

Health Solutions Legal Consultant (AVP) - Compliance & Policy Consulting

Remote, USAFull-time

Clinical Compliance reputed company Consultant/RN/LPC/LCSW- Central Virginia (Fredericksburg, Stafford, Spotsylvania)

Remote, USAFull-time

Clinical Risk Investigator

Remote, USAFull-time

reputed company reputed company Analysts

Remote, USAFull-time

Scientific reputed company and Partnerships Specialist

Remote, USAFull-time

reputed company Live Chat Remote Representative – reputed company reputed company reputed company

Remote, USAFull-time

Desarrollador Backend Junior (.NET / C#) │ Remoto

Remote, USAFull-time

reputed company Customer Service Associate - Work from Home Opportunity at arenaflex

Remote, USAFull-time

Patient Care Navigator - Remote

Remote, USAFull-time

Teen Tour Counselors

Remote, USAFull-time

reputed company Customer Service Representative – Remote Work Opportunity at arenaflex

Remote, USAFull-time

reputed company Medical Record and Data Entry Clerk – Project Support Specialist for Health Information Management and reputed company reputed company Services

Remote, USAFull-time

Remote Closer (High Ticket)

Remote, USAFull-time

Utilization Management reputed company Consultant – Behav...

Remote, USAFull-time