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 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 :

• 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. 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.
• Leads projects within assigned regulatory and legislative focus areas, including the identification of key business issues, legislative or regulatory analysis. Develops comment letters and resources for policymakers and educational materials for BCBS Plans. 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.
• 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 to assess current landscape, identify opportunities for engagement for BCBSA leadership, and assist with implementing a forward-thinking, comprehensive, coordinated, strategy for assigned programs and / or issues.
• Keeps up to date on legislative and regulatory positions and priorities, strategies, federal policymaking activities, external stakeholder positioning, and health care issues generally in order to maintain an understanding of key issues and strategies. May provide policy support to State Affairs team and work with state-based organizations (SBOs). Takes on various health policy projects as assigned.
• Collaborates with BCBS Plan representatives, Policy and Advocacy staff and broader BCBSA staff. Engages with external stakeholders including federal policymakers and third-party representatives as appropriate.
• Ensures senior management, senior leadership team and BCBS Plan representatives are informed as to pertinent legislative and regulatory developments.

The posting range for this position is :

$111,878.00-$160,925.77

Required Education, Certifications and Experience :

Education :

Experience :

Knowledge Skills and Abilities :

Additional Preferred Experience :

Experience working on one or more of the following Medicare Advantage policy areas : Stars program, Quality Bonus Payments, Medicare Advantage prescription drug plans, fraud, waste and abuse in Medicare, prior authorization processes and utilization management in Medicare, and telehealth policies.

Additional experience with Health insurance contracts and payment structures specific to Medicare Value-based care models and affordability initiatives in Medicare

Policy and legislative analysis related to Medicare regulations and legislation

Prior experience working for a health insurer, Congress, the Administration, or third-party stakeholders focused on Medicare programs is highly desirable. Experience working with public officials or in government is also valued.

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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. We may ultimately pay more or less than the hiring range and this hiring range may also be modified in the future. 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, seniority, performance, shift, travel requirements, 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. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.