Job Description Summary:
The Healthcare Solutions Counsel-Federal Employee Program (FEP) provides legal and strategic guidance to the FEP team and the broader BCBSA Business Operations division on high profile matters related to healthcare delivery, with an emphasis on managing the ongoing interpretation of regulatory requirements promulgated by, and contractual arrangements with, the U.S. Office of Personnel Management (OPM) and the Centers for Medicare and Medicaid Services (CMS). This role involves representing BCBSA in healthcare benefits negotiations for FEP, supporting internal client and Plan legal and policy questions related to healthcare benefits and payments, and supporting the resolution of complex government audits. The position requires deep healthcare knowledge and experience, including within the Federal Employees Health Benefits Program and Medicare Advantage, in order to provide advice and counsel across FEP business teams.
Responsibilities include but are not limited to:
Deep knowledge of US healthcare industry; experience with Medicare Advantage and the Federal Employee Health Benefits Program preferred.
Demonstrated ability to interpret and apply regulatory requirements and to develop strategies that strengthen and optimize relationships with government entities.
Experience working within OPM and/or CMS, or in private practice in support of federal healthcare programs.
Capacity to guide the team in meeting regulatory requirements during benefit changes, with proficiency in reviewing and interpreting OPM guidance and annual call letters.
Understanding of government agencies’ perspectives and approaches to contract management and audit response.
The posting range for this position is:
$142,690.00-$205,246.50
Required Education, Certifications and Experience:
Education:
Experience:
Knowledge, Skills and Abilities:
Proficient written and oral communication skills
Proficient organizational and project management skills, including follow through skills
Strong legal research, analysis and drafting
Problem solving skills
Preferred knowledge of healthcare insurance industry, including state and federal regulatory environment
Certifications & Licenses
Additional Preferred Experience:
- Legal, Policy or Audit experience in Healthcare, FEP, CMS, OPM, Medicare Advantage
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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 andthis hiringrange 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 bonusincentivepay.
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.
