Hiring: Regulatory Compliance Manager (Hybrid) Company: CareFirst BlueCross BlueShield Location: Baltimore, MD Job Posted Time: 2026-09-10 11:49:29 Target Skills & Keywords : Medicaid, Medicare, Regulatory Compliance, Risk Management, Vendor Management About the job Experience: •5 years experience in health insurance industry, managed care and government programs, health insurance compliance programs, CTM or complaint operations, vendor & delegated entity compliance and oversight, or related fields.1 year supervisory experience or demonstrated progressive leadership experience. Required Skills: •Prepares, analyzes, and presents CTM, vendor compliance, audit, and risk reports to leadership, compliance committees, and operational stakeholders. Identifies trends, systemic issues, and emerging risks and recommends actions to improve compliance performance, operational efficiency, and member experience. •Leads associate performance, training, and development activities to support effective CTM process management, vendor oversight, audit readiness, and regulatory compliance. Creates and discusses performance plans and reviews, identifies development needs, and ensures staff adhere to policies, procedures, and established compliance processes. •This position manages people. Qualifications: •Bachelor's Degree in Healthcare Compliance, Risk Management, Business Administration or related field 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. •Knowledge, Skills And Abilities (KSAs) •Incumbent must display leadership qualities, functional expertise, and business perspective. •Excellent interpersonal skills with ability to build consensus and agreement and bring resolution to contentious issues and entrenched interests. •Demonstrated capacity to research complex issues, interpret CMS Medicare Advantage regulations and regulatory guidance, apply sound judgment to CTM process management, complaint handling, vendor and delegated entity compliance and oversight, and operational compliance matters. •Demonstrated ability to lead problem-solving discussions. •Strong organizational, coordination, reporting, and interpersonal skills for facilitating compliance audits, CTM oversight, vendor management compliance, and cross-functional issue resolution. •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. Compensation: •$113,760 - $211,167 / year •Competitive benefits and rewards package Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!