Enterprise Regulatory Compliance Program Lead

Excellus BCBS; City of Albany (NY); Hybrid; USD 65,000 - 118,000; Full time

Job summary

Excellus BCBS is seeking an Enterprise Regulatory Compliance Program Administrator to translate regulatory guidance into practical risk-based compliance solutions across enterprise processes, products, and operations.

The role partners with multiple business areas to monitor regulatory changes, perform impact assessments, support audits, and advise partners to ensure ongoing compliance with CMS, NY DOH, DFS, DOL, OIG, OMIG, and other authorities.

Qualifications

• Seven or more years’ experience in health insurance or health care delivery, or bachelor’s degree in related area with four or more years of related experience.
• Working knowledge of federal and state health care regulatory frameworks affecting Medicare, Medicaid, and commercial products.
• Advanced knowledge of health insurance regulations and compliance program operations.
• Demonstrated experience managing multiple complex regulatory initiatives or compliance projects.
• Strong project coordination skills with the ability to manage multiple priorities.

Responsibilities

• Interpret federal and state regulatory guidance and provide clear, practical guidance to business partners regarding company products, services, and operations.
• Monitor changes in regulations at state and federal levels and assess impact on programs and systems.
• Collaborate with cross-functional teams to support regulatory compliance readiness and implementation.
• Assist in regulatory risk assessments and remediation planning.
• Support audits or examinations by internal teams and external regulators.

Skills

Regulatory compliance

Healthcare regulations

Policy interpretation

Cross-functional collaboration

Project coordination

Audit support

Communication skills

Education

Bachelor's degree in related area

Certification preferred (CPCO/CHC/CHPC/HCCA)

Tools

Microsoft Office

Enterprise systems

Job description

Excellus BCBS is seeking an Enterprise Regulatory Compliance Program Administrator to translate regulatory guidance into practical risk-based compliance solutions across enterprise processes, products, and operations.

The role partners with multiple business areas to monitor regulatory changes, perform impact assessments, support audits, and advise partners to ensure ongoing compliance with CMS, NY DOH, DFS, DOL, OIG, OMIG, and other authorities.