CareFirst Careers

Regulatory Project Manager (Consumer Direct)

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Resp & Qualifications

PRINCIPAL ACCOUNTABILITIES: The incumbent is responsible for, but are not limited to, the following:

Day to Day Management of ACA Open Enrollment and Renewals

Manages the day-to-day activities and schedule for the annual ACA Open Enrollment period for the Consumer Direct SBU.  Works with direct management on goals, tasks and timelines that allow for the renewals and Open Enrollment annual cycle to be successful.  Interacts daily with members of various SBU departments to ensure compliance with the project activities and work with them on execution of those activities. 

Assists with determining project goals and priorities with management, program manager and/or project sponsors. Assists on creating all project planning documentation (including updates, status reports, etc.) and follows all CareFirst project methodologies (discovery documents, charters, etc.). Establish and publish clear priorities among project activities to produce a business plan in accordance with the strategic plan, operating budget, capital planning procedures and agency guidance. Coordinates team activities to meet project milestones.

Works with sponsors and stakeholders to develop a business case on the cost/benefit of the proposed project for presentation to management for review and approval.  Works with business leads to define and manage operational readiness. Identifies standards or requirements for change management. Participates in change control (for example, reviewing configuration change requests).  Develops or implements information systems security and entitlement requirements and plans; and ensures appropriate product-related training and documentation are developed and made available to customers.

Manage and communicate a clear vision of the projects objectives, and motivate the cross functional project team to achieve them; create a project environment that enables peak performance by the entire team.

Establishes and publishes clear priorities among project activities.  Coordinates team activities to meet project milestones.

Directs/leads project teams comprised of subject matter experts, technical specialists, and support staff to produce a business plan in accordance with the strategic plan, operating budget, capital planning procedures.. 

Prepares, implements, monitors, and updates the project plan.  Coordinates with the business owner and upper level management to ensure the actions are consistent with the approved plan.

Regulatory Compliance and Analysis

Interpret and analyze new and/or modified regulations that impact the SBU.  Responsible for a full understanding of the regulatory foundation of assigned projects.  Provide guidance to project team and business partners to align regulatory requirements to operational requirements in a manner that balances cost and business needs to provide maximum value to CareFirst.

Project Management of Open Enrollment and ACA System Enhancements

Manage the project lifecycle (SDLC) for any system enhancements that are funded each year as a result of business-defined needs related to ACA and Open Enrollment.

Oversees the design, construction, testing, and implementation of technical and functional specifications of a project technology system.  Develops information systems testing strategies, plans or scenarios.

Analyze risks, establish contingency plans and identify trigger events and responsibility for initiating mitigating action. Gather stakeholder input, rank the top projects risks in terms of total impact. Accountable for tracking and reporting on progress to plan, cost and schedule reporting and change control. Manage change to preserve business plan commitments; initiate review if projects must change.

Communicate risks to stakeholders and business sponsors, escalate issues and risks for mitigation. Manage relationships with project stakeholders, including internal and external clients and vendors, keeping stakeholders informed of progress and issues in order to manage expectations on all project requirements and deliverables. Facilitate regularly scheduled project meetings for the project team, workgroup, executive steering committee, risk planning and change control.

Proactively identify changes in work scope and ensure appropriate planning measures are taken with internal and external clients to reassess and amend the scope of work requirement, budget and timeline.

Mandates Operational Readiness

Manage the intake process for all regulatory and mandated changes that impact the Consumer Direct SBU.  Work with each operational area within the SBU to determine impacts of the changes and ensure that each area is operationally ready for the upcoming change.

Maintain and update the operational transition process as necessary based on user feedback from within the SBU and external partners. 

Communicate to SBU management, via dashboard reporting, on the operational readiness status of all in-flight mandated changes at any given time. 

Ensure clear lines of communication between the SBU and the TOS/Mandates team on corporate initiative and day-to-day projects funded by TOS


Required Education and Experience:
Required: This position requires a four-year degree (preferably in CIS/MIS, healthcare administration, public policy) as well as 2-4 years of related project management experience in a large scale, cross functional, multi-system environment.

Out of the  2-4 years required, at least 2 years in a combination of the following:

  • Progressive broad-based Project Management experience (which could include consulting) is desirable; knowledge and implementation experience in new computing architectures and networked computing struc¬tures. 
  • Experience as Project Manager, with working knowledge of  Systems development lifecycle and the Project Management Lifecycle

Required Skills and Abilities:

  • Ability to lead dynamic, energized, and highly creative multidiscipline high-performance work teams in learning and applying new skills/techniques to respond to business needs.
  • Leadership skills including:  coaching, organizing, integrating, directing, controlling and motivating.
  • Ability to communicate effectively between TOS and the business on impacts and needs that are jointly shared by both areas. 
  • Ability to effectively adapt to rapidly changing technology and apply it to business needs.
  • Experience managing and delivering Business and IT centric projects using (where appropriate) leading-edge technology, and older legacy systems. 
  • Solid teamwork and interpersonal skills, with the ability to communicate and persuade customers, employees, and management at all levels and thrive in a cross-functional environment. 
  • Excellent oral and written communications; an ability to present and discuss technical information in a way that establishes rapport, persuades others, and gains understanding.
  • Exceptional project management skills, effectively arranging resources and managing small to moderate projects in a cross-functional environment, work flow balancing, activity scheduling, problem resolution and flexibility
  • Ability to analyze project needs and determine resources needed to meet objectives, possess good technical skills including scheduling, estimating and costing
  • Strong analytical, problem-solving, and conceptual skills.
  • Knowledge of local systems and experience with hardware, software and high level programming is required in order to understand the effect a new project will have throughout all related systems.
  • MS Office proficiency.
  • MS Project and Visio proficiency.


  • Prior Health insurance industry exposure, specific experience with successful project implementations. 
  • Prior knowledge and experience with the Affordable Care Act and Exchanges.
  • Experience with or understanding of software development concepts and fundamentals.


Department: Consumer Direct - Operations Mandates Support

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Hire Range Disclaimer

Actual salary will be based on relevant job experience and work history.

Where To Apply

Please visit our website to apply:

Closing Date

Please apply before: 8/15/2018

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on federal health care programs.

The physical demands described here are representative of those that must be met by an associate to perform the essential duties and responsibilities of the position successfully.  Requirements may be modified to accommodate individuals with disabilities.

The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights of up to 10 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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