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Director Medicare Policy

Employment type: 
Full time
Remote Position: 
Required degree level: 


Identifies and proactively develops BCBSA's Medicare policy, including regulatory and legislative policy related to all aspects of Medicare, including Medicare Advantage, Medicare Part D, Medigap, and Fee-for-Service Medicare. Conducts policy analysis, development and drafting of BCBSA regulatory responses, supporting the development and execution of modeling and research, and supports legislative analysis. Supports BCBS Medicare Plan work groups dedicated to Medicare and ensures that the strategy implemented for specific policy is representative of BCBSA and Plan objectives. Accountable for policy research, synthesis and development of materials that advance BCBSA Medicare policy objectives.


Responsibilities include but are not limited to:


  • Analyze, identify and prioritize key BCBSA business issues in Federal legislative, regulatory, and 3rd Party/Think Tank proposals. Collaborate with peers and others in BCBSA's 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, Medicare strategy. Determines and recommends the necessary policy strategy and legislative actions that should be executed to respond to policy issues.


  • Develop, analyze and draft public comment responses and supporting materials for manager and OPR Leadership for policy approval by OPR's workgroups and committees. Conduct policy research and synthesizes information to inform policy development process. Work with manager to assure Plan business issues are represented in BCBSA Medicare policy positions.


  • Develop written and oral communications that advance the objectives of OPR and BCBSA and provide relevant information and educational materials about legislative activities to member Plans, legislators and other interested parties. Works with lobbyists to ensure coordination of activities and the continual monitoring/assessment of issues, positions, and potential project needs.


  • Develops bill summaries, policy analysis and memos on key issues and BCBSA positions for use by Plans. Participate in BCBSA and Plan meetings to inform staff of key issues and actions taken by OPR staff.

Other Job Functions:

  • Keeps up-to-date on developments in relevant policy subjects in the media, Congress, Administration and third-party stakeholders. Maintains knowledge of BCBSA legislative and regulatory positions and priorities, strategies, state and congressional activities, and healthcare issues generally in order to maintain an understanding of key OPR issues and strategies. Maintains liaisons with other policy experts on issue areas and represents the Association in coalitions or other interest/representative groups. Takes on various health policy projects as assigned.


Required Basic Qualifications:

  • 6 years of experience working with Medicare-related regulation and legislation
  • Experience developing and drafting policy analysis with focus on Medicare and related matters to Congress, government agencies and/or other legislative bodies
  • Understanding and knowledge of the federal legislative and regulatory process
  • Experience working on health plan-related Medicare issues
  • Proven ability to structure research policy studies, modeling and formulate policy alternatives
  • Master's Degree
  • BA/BS, MPH, MHS, MA, MBA or related master's degree
  • Analyzing and synthesizing complex legislative, regulatory and other industry proposals and identifying business implications for BCBS Plans and BCBSA
  • Ability to rapidly formulate and communicate complex legislative and regulatory issues in a concise and understandable way to a variety of audiences including executives and business and operational leadership
  • Outstanding written and oral communications skills: writes persuasively, presents to varied and large audiences, able to facilitate large conference calls
  • Works confidently under pressure and is agile in managing through ambiguity and adapting to changing priorities
  • Ability to draw upon extensive knowledge and relationships to identify and analyze issues and develop appropriate policy strategies and responses, demonstrating excellent judgment and analytical methodologies
  • Sophisticated/strategic thinking to determine how best to influence decision/policy makers
  • Demonstrated ability in setting and meeting objectives, while reacting within a growing and changing internal and external environment
  • Superior facilitation, presentation, organizational and verbal and written skills, with the demonstrated ability to work independently

Preferred Basic Qualifications:

  • JD or Masters in public health, public policy, health policy or related field or equivalent experience
  • 6+ years of experience working with health information technology related regulation, legislation and/or law
  • Extensive experience developing and drafting policy and legal analysis with focus on Medicare-related matters
  • Understanding of Medicare Advantage payment structure, including risk adjustment
  • Prior experience working for Congress, the Administration or third party stakeholders focused on Medicare policy
  • Masters in MPH, MHS, MA, MBA or related master's degree, JD

Equal Opportunity Employer

Blue Cross Blue Shield Association is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, national origin, age, gender identity, disability, veteran status, genetic information or any other legally protected characteristics

Make an impact on healthcare in America. A career with Blue Cross Blue Shield Association allows you to be part of the foundation that supports the 35 Blue Cross and Blue Shield companies nationwide, while protecting and strengthening the Blue Cross Blue Shield brand. Our work is helping provide greater access to cost-effective healthcare, improve the health of America and build stronger communities. With a commitment to diversity, equity and inclusion, we celebrate different cultures, languages, backgrounds and experiences while striving to advance health equity, and we want you to join Team BCBSA.

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