Legislative and Regulatory Senior Policy Program Manager (Medicare Advantage)

Job Description Summary
This role identifies and proactively develops policy recommendations that further the BCBS mission and drive solutions. Identifies and analyzes proposed regulatory and legislative initiatives at the federal and state level which present significant implications to BCBS Plans’ members and clients. Identifies policy questions, advances meaningful policy solutions, and builds consensus with BCBS Plans and stakeholder allies on high-profile issues.

Prepares formal comments regarding recommended policies and communicates key updates from BCBSA and federal/state policymakers to BCBS Plans. Leads BCBS Plan workgroups to advance corporate goals for assigned programs and/or issues. Works closely with BCBSA leadership to develop strategy around regulatory and legislative priorities for engagement with the White House, Administration, Congress and other key stakeholders in Washington.

A strong knowledge of the Medicare Advantage program and Medicare payment systems is required, with the ability to demonstrate expertise in these areas and apply this knowledge to policy analysis and development.

Responsibilities include but are not limited to:
Policy Development: Leads the development of effective, consensus-based policy recommendations to promote BCBSA and BCBS Plan objectives at both state and federal levels. Manages the review of legislation and regulations to identify and provide feedback to policymakers and staff on strategic and business considerations.

Advocacy & Documentation: Develops advocacy documents to support these activities, including key messaging, one-pagers, and briefing materials. Provides policy support for coalitions, third-party inquiries and internal business partners on select focus areas. Brings forward new ideas and strategic thinking to promote BCBSA priorities and objectives.

Project Leadership: Leads projects within assigned regulatory and legislative focus areas, including the identification of key business issues and legislative or regulatory analysis. Develops comment letters and resources for policymakers and educational materials for BCBS Plans.

Communications: Produces bill summaries, policy analysis and memos on key issues and BCBSA positions for use by Plans. Leads BCBSA and Plan meetings to inform staff of key issues and actions taken by P&A staff. Responsible for researching and developing responses to Plan inquiries.

Collaboration: Leads workgroup and related calls on focus areas. Identifies and communicates key regulatory and legislative activities to internal audiences, BCBS Plans and other external audiences. Collaborates with peers and others on BCBSA’s business/operations team to support synchronized efforts.

Strategic Alignment: Keeps up to date on legislative and regulatory positions and priorities, strategies, federal policymaking activities, external stakeholder positioning, and health care issues generally. May provide policy support to State Affairs team and work with state-based organizations (SBOs).

Reporting: Ensures senior management, senior leadership team and BCBS Plan representatives are informed as to pertinent legislative and regulatory developments.

Salary Range
The posting range for this position is: $111,878.00 – $160,925.77

Required Education, Certifications and Experience
Education:

Required: Bachelor’s Degree in Political Science, Public or Health Policy, Business or Public Administration; or equivalent work experience.

Preferred: Master’s Degree in Health Policy, Public Policy, Health Administration, Public Heath or relevant subject.

Experience:

7+ Years equivalent work experience (Required).

Knowledge, Skills and Abilities
Advanced knowledge of health care systems and understanding of legislative and policymaking process.

Strong communications skills; the ability to communicate effectively and persuasively, both orally and in writing.

Strong planning and organizational skills.

Strong human relations skills; ability to work with others in obtaining feedback/input, accomplishing goals, and meeting deadlines.

Sophisticated/strategic thinking to determine how best to influence decision/policy makers.

Comprehensive understanding of health policy issues and the legislative process, as well as experience with policy writing.

Excellent interpersonal skills; demonstrated ability to develop and maintain relationships and influence outcomes.

Demonstrated ability to manage time and competing priorities.

Additional Preferred Experience
Medicare Advantage Policy: Stars program, Quality Bonus Payments, Medicare Advantage prescription drug plans, fraud, waste and abuse, prior authorization processes, and telehealth policies.

Contracting & Payment: Experience with Health insurance contracts and payment structures specific to Medicare Value-based care models and affordability initiatives.

Analysis: Policy and legislative analysis related to Medicare regulations and legislation.

Background: Prior experience working for a health insurer, Congress, the Administration, or third-party stakeholders focused on Medicare programs is highly desirable.

Additional Information
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The posted salary range is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, and business or organizational needs. This job is also eligible for annual bonus incentive pay.

We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable.

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