CareFirst BlueCross BlueShield
Posted 53 days agoVerified live 1d ago
Regulatory Operations & Mandates Project Manager IT (Remote)
Brief overview
Remote
UndergradOr in progress
$90k–$178k/yrStated range
3+ yrsMinimum
Certified Project Management Professional (PMP)SAFe Scrum Master CertificationRegulatory ComplianceHealthcare Laws and RegulationsCommercial and Government Programs MedicareCommercial and Government Programs MedicaidCommercial and Government Programs FEHBPHealth Plan Operations BenefitsHealth Plan Operations ClaimsHealth Plan Operations ProviderHealth Plan Operations EnrollmentFinancial ManagementProject FinancialsTechnical Systems ImplementationRegulatory ReportingStakeholder ManagementProject Management
About the company
CareFirst BlueCross BlueShieldindividual.carefirst.com
CareFirst. It’s not just our name. It’s our promise.
Job description
Summary
CareFirst BlueCross BlueShield is seeking an IT Project Manager for Regulatory Operations & Mandates. This role is responsible for leading the planning and delivery of projects driven by regulatory requirements, ensuring compliance obligations are integrated into project delivery, and serving as a liaison between various stakeholders.
Responsibilities
- Translate legal interpretations of regulatory requirements into business and system compliance requirements
- Analyze impacts across products, funding types (Commercial, ASO, Government Programs), and operational areas
- Identify impacted stakeholders, systems, and processes to define project scope and requirements
- Partner with Legal and business teams to clarify requirements and resolve interpretation questions
- Track and monitor regulatory milestones and effective dates throughout the project lifecycle
- In conjunction with the ePMO PM, develop and manage project plans, timelines, deliverables, and resource allocation
- Ensure regulatory and business requirements are fully integrated into project scope and facilitate a detailed handoff to ePMO to initiate execution phase
- Monitor risks, issues, and dependencies, with a focus on compliance and operational impact
- Serve as liaison between Regulatory Operations, Legal, IT, and business stakeholders
- Lead cross-functional discussions to align implementation approach, requirements, and timelines
- Provide regulatory guidance to project teams and influence decision-making
- Ensure compliance documentation and audit-ready evidence is completed and maintained in tracking system/site
- Provide regular project status updates and reporting to leadership
- Support regulatory reporting efforts, including ad hoc and complex reporting requests, by partnering with Lead Reporting Analyst, as needed, to ensure accuracy, completeness, and alignment with regulatory requirements
Skills
- Bachelor's Degree in Health Informatics, Information Technology, Information Systems or related discipline OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience
- 3 years experience leading projects in a cross-functional, technical systems implementation
- Certified Project Management Professional (PMP)-PMI
- SAFe Scrum Master Certification
- Experience interpreting or operationalizing state and federal healthcare laws/regulations
- Knowledge of Commercial and Government Programs (e.g., Medicare, Medicaid, FEHBP)
- Experience translating regulatory or legal requirements into business and technical solutions
- Experience working within an EPMO or supporting system implementations
- Familiarity with health plan operations (e.g., benefits, claims, provider, enrollment)
- Experience supporting regulatory compliance initiatives or audits
Qualifications
Must Haves
- Bachelor's Degree in Health Informatics, Information Technology, Information Systems or related discipline OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience
- 3 years experience leading projects in a cross-functional, technical systems implementation
Nice to Haves
- Certified Project Management Professional (PMP)-PMI
- SAFe Scrum Master Certification
- Experience interpreting or operationalizing state and federal healthcare laws/regulations
- Knowledge of Commercial and Government Programs (e.g., Medicare, Medicaid, FEHBP)
- Experience translating regulatory or legal requirements into business and technical solutions
- Experience working within an EPMO or supporting system implementations
- Familiarity with health plan operations (e.g., benefits, claims, provider, enrollment)
- Experience supporting regulatory compliance initiatives or audits
Benefits
- A comprehensive benefits package
- Various incentive programs/plans
- 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements)
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