Director, Legislative and Regulatory Policy (Medicaid)

About the position This Director-level position is a people leader and strategic owner of BCBSA's Medicaid policy portfolio, driving the vision and agenda for legislative and regulatory engagement in collaboration with senior leadership. Responsible for developing and leading strategies to influence legislation, regulations, and key stakeholders. Manages identification of business issues, evaluates impacts, and prepares advocacy materials. Engages with Administration officials to advance BCBSA positions and collaborates with senior staff to ensure third-party engagement. Identifies collaboration opportunities to advance BCBSA Board priorities. Represents the department in internal and external groups, overseeing strategies to showcase Blue Plan innovations and advance policies on priority and emerging issues. Responsibilities include but are not limited to: Lead Discussions and Research: Lead discussions on key issues in Plan workgroup calls, coordinate with BCBSA divisions and consultants, and implement research agendas for issue areas. Identify and Evaluate Business and Policy Issues: Anticipate and identify key business and policy issues. Oversee staff and consultants to review legislation, regulations, and guidance, ensuring strategic and business issues for Plans are evaluated. Manage Regulatory and Legislative Projects: Direct and coordinate projects within regulatory and legislative areas, including policy analysis, development of comments, and educational materials. Represent BCBSA in meetings with policymakers and influential organizations. Develop and Maintain Key Relationships: Build and maintain relationships with BCBSA representatives, policymakers, and external organizations. Play a leadership role with third-party stakeholders and serve as liaison with regulatory representatives. Manage staff to foster a positive work environment and ensure appropriate training and development. Provide Policy Input and Support: Offer policy input and support to State Affairs on NAIC and state-related initiatives, ensuring alignment with federal policy positions. Formulate and Communicate Strategies: Develop strategies on an issue-by-issue basis, ensuring consensus among Plans. Communicate implications and effects to Plans and promote Plan initiatives to stakeholders.

Responsibilities

• Lead Discussions and Research: Lead discussions on key issues in Plan workgroup calls, coordinate with BCBSA divisions and consultants, and implement research agendas for issue areas.
• Identify and Evaluate Business and Policy Issues: Anticipate and identify key business and policy issues. Oversee staff and consultants to review legislation, regulations, and guidance, ensuring strategic and business issues for Plans are evaluated.
• Manage Regulatory and Legislative Projects: Direct and coordinate projects within regulatory and legislative areas, including policy analysis, development of comments, and educational materials.
• Represent BCBSA in meetings with policymakers and influential organizations.
• Develop and Maintain Key Relationships: Build and maintain relationships with BCBSA representatives, policymakers, and external organizations. Play a leadership role with third-party stakeholders and serve as liaison with regulatory representatives.
• Manage staff to foster a positive work environment and ensure appropriate training and development.
• Provide Policy Input and Support: Offer policy input and support to State Affairs on NAIC and state-related initiatives, ensuring alignment with federal policy positions.
• Formulate and Communicate Strategies: Develop strategies on an issue-by-issue basis, ensuring consensus among Plans. Communicate implications and effects to Plans and promote Plan initiatives to stakeholders.
• Lead Cross-Functional Collaboration: Partner with internal divisions including advocacy, operations, and communications to ensure cohesive Medicaid policy messaging and execution; build and maintain strong working relationships across the organization to advance shared priorities and drive alignment on the Medicaid policy agenda.
• Lead and Develop Staff: Manage a small team of policy professionals, providing direction, mentorship, and development opportunities. Foster a collaborative and high-performing work environment, ensuring staff are equipped to execute on the Medicaid policy agenda.

Requirements

• Required Bachelor's Degree in Political Science, Public Health, Public Administration or related field; or equivalent work experience
• 10+ Years experience in health care policy analysis/formulation, health care law, state insurance regulations and/or healthcare plan operations, with experience in public health policy
• Extensive knowledge of managed care and insurance reform issues, operations and policy, as well as knowledge of the federal legislative and regulatory process.
• Extensive knowledge of commercial health insurance markets and ERISA rules affecting group health plans
• Sophisticated/strategic thinking to determine how best to influence decision/policy makers
• Superior facilitation, presentation, organizational and verbal and written skills, with the demonstrated ability to work independently
• Analytical, planning and project management skills, as well as the ability to prioritize and shift multiple issues and projects without compromising quality results
• Minimum 10 years’ experience in health care policy analysis/formulation, health care law, state insurance regulations and/or healthcare plan operations, with experience in public health policy.
• Expertise across the Medicaid landscape, including Medicaid managed care, CHIP, Medicaid financing, and the federal and state waiver landscape (e.g., 1115, 1915(b/c) waivers), with the ability to set strategic direction across a complex policy portfolio
• Demonstrated experience with dual-eligible populations, including Medicare-Medicaid integration, D-SNPs and FIDE-SNPs
• Proven people management experience, including leading, mentoring, and developing policy professionals
• Demonstrated ability to develop and drive a Medicaid policy agenda, including setting priorities, building consensus among Plans, and advancing organizational positions with policymakers and stakeholders
• Experience in communicating and writing comments to Congress, government agencies and/or other legislative bodies
• Experience supporting research policy studies and formulating policy alternatives

Nice-to-haves

• Preferred Master's Degree in public policy, health policy or related field.
• Membership in American Academy of Actuaries

Benefits

• paid time off
• 11 holidays
• medical/dental/vision insurance
• generous 401(k) matching
• lifestyle spending account
• annual bonus incentive pay

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