Note: The job is a remote job and is open to candidates in USA. 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
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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