Regulatory Program Manager

2 weeks ago

Wilmington, North Carolina, United States Johns Hopkins Medicine Full time

Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here.

What awaits you:

  • Work-life balance - This is a remote role
  • Medical, Dental, and Vision Insurance.
  • 403B Savings Plan w/employer contribution.
  • Paid Time off & Paid holidays.
  • Employee and Dependent Tuition assistance benefits.
  • Health and wellness programs and MORE

As a Regulatory Program Manager, you'll:

  • Manage NCQA and EQRO (External Quality Review Organizations) program requirements across all lines of business.
  • Be responsible for managing and improving major cross-functional programs with substantial regulatory implications.
  • Develop and manage a comprehensive program action plan, including facilitation and management of performance reporting, that involves stakeholders across the organization and includes external business partners.
  • Develop the education, reporting, tools, and transformation related work plans designed to support JHHPs accreditation and regulatory requirements.
  • Create best practice workflows and process mapping for optimal delivery regulatory and accreditation requirement.
  • Engage in continual assessment of program effectiveness, identifying opportunities to drive process improvement across stakeholders and lines of business.

What you'll bring:

  • 5+ years of demonstrated performance experience within a health care and/or managed care environment.
  • Bachelor's degree required, with a concentration in Business Management preferred.
  • Experience with Medicare, Medicaid and commercial health plans as it relates to accreditation and regulatory requirements preferred.
  • Requires extensive knowledge of NCQA Health Plan Accreditation Retirements, NCQA Health Plan Ratings, CAHPS, and State Medicaid EQRO audits.

Who we are:

Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3B business serving over 500,000 active members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHP is a leader in provider-sponsored health plans and is poised for future growth.

Many organizations talk about transforming the future of healthcare, at Johns Hopkins Health Plans, we are setting the pace for change within the healthcare industry. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.

  • Spectrum Program Manager

    3 days ago

    Wilmington, North Carolina, United States Amentum Full time

    Amentum is a leading provider of enduring support for the essential missions of the U.S. government, its allied partners, and international organizations. With over 60 years of experience, Amentum supports the execution of complex and critical missions by providing engineering and technical services, operations support and national security solutions to...

  • Program Manager

    4 days ago

    Wilmington, North Carolina, United States Amentum Full time

    Amentum is a leading provider of enduring support for the essential missions of the U.S. government, its allied partners, and international organizations. With over 60 years of experience, Amentum supports the execution of complex and critical missions by providing engineering and technical services, operations support and national security solutions to...

  • program manager

    1 month ago

    Wilmington, North Carolina, United States Department Of Defense Full time

    Summary DCSA's Adjudication and Vetting Services (AVS) is looking for a Program Management Specialist to be responsible for managing and coordinating DCSA's enterprise and AVS cross-functional information technology (IT) related activities and initiatives that affect the AVS mission and workforce. Interested in National Security? Consider DCSA and be part...

  • Manager of Systems Configuration

    2 weeks ago

    Wilmington, North Carolina, United States Johns Hopkins Medicine Full time

    Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here. What awaits you: Work-life balance - This is a hybrid role requiring you to work 1 day per week in the Hanover, MD...

  • Manager Pharmacy Clinical OPS

    3 hours ago

    Wilmington, North Carolina, United States Johns Hopkins Medicine Full time

    Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here. What awaits you: Work-life balance - This is a hybrid role requiring you to work 1 day per week in the Hanover, MD...

  • Senior Project Manager

    6 days ago

    Wilmington, North Carolina, United States Mace Full time

    At Mace, our purpose is to redefine the boundaries of ambition. We believe in creating places that are responsible, bringing transformative impact to our people, communities and societies across the globe. To learn more about our purpose, culture, and priorities, visit our strategy site. Within our consult business, we harness our unique combination of...

  • General Manager

    2 weeks ago

    Wilmington, North Carolina, United States TownePlace Suites by Marriott Arundel Mills BWI Airport Full time

    Who this job will appeal toYou bring the passion, motivation, and drive, and Aimbridge Hospitality will bring the opportunities Aimbridge will get you where you want to go and help you reach places in your career you might have never imagined were possible When you join the Aimbridge Family, you're working with the best of the best It's a mark of...

  • Manager, AMD Sales

    2 weeks ago

    Wilmington, North Carolina, United States Johns Hopkins Medicine Full time

    Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here. What awaits you: Work-life balance Medical, Dental, and Vision Insurance.403B Savings Plan w/employer...

  • Vice President, Family Health Plan- Johns Hopkins Health Plans

    2 weeks ago

    Wilmington, North Carolina, United States Johns Hopkins Medicine Full time

    Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3.2B business serving nearly 500,000 members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHP is a leader in provider-sponsored health plans—backed by the clinical...

  • Marketing Project Specialist

    3 days ago

    Wilmington, North Carolina, United States Johns Hopkins Medicine Full time

    Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here. What awaits you: Work-life balance - This is a hybrid role requiring you to work 1 day per week in the Hanover, MD...

  • Senior Administrative and Management Support

    5 days ago

    Wilmington, North Carolina, United States Amentum Full time

    Amentum is seeking a Senior Administrative and Management Support. The AA independently accomplishes general or routine office administrative tasks. The AA should have the expertise and qualifications to accomplish moderately complex administrative tasks with minimal guidance and assistance. Depending on the customer office, some tasks can be more dynamic...

  • Senior Administrative and Management Support

    7 days ago

    Wilmington, North Carolina, United States Amentum Full time

    Amentum is seeking a Senior Administrative and Management Support. The AA independently accomplishes general or routine office administrative tasks. The AA should have the expertise and qualifications to accomplish moderately complex administrative tasks with minimal guidance and assistance. Depending on the customer office, some tasks can be more dynamic...

  • Senior Project Manager

    7 days ago

    Wilmington, North Carolina, United States Mace Full time

    At Mace, our purpose is to redefine the boundaries of ambition. We believe in creating places that are responsible, bringing transformative impact to our people, communities and societies across the globe. To learn more about our purpose, culture, and priorities, visit our strategy site. Within our consult business, we harness our unique combination of...

  • Delivery Lead, Manager

    9 hours ago

    Wilmington, North Carolina, United States Mondelēz International Full time

    Job Description Are You Ready to Make It Happen at Mondelēz International? Join our Mission to Lead the Future of Snacking. Make It With Pride. You provide software and application knowledge to support implementation of the given solutions.Together with analytics team leaders you will support our business with excellent Data & Analytics products to uncover...

  • Senior Financial Analyst

    2 weeks ago

    Wilmington, North Carolina, United States Johns Hopkins Medicine Full time

    Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here. What awaits you: Work-life balance - This is a remote role You may be asked to come to the office once per...

  • supervisory personnel security specialist

    2 weeks ago

    Wilmington, North Carolina, United States USAJobs Full time

    DutiesThis position in the Adjudication and Vetting Services (AVS), an office within the Defense Counterintelligence and Security Agency (DCSA), Department of Defense (DoD). Under supervision and guidance from Deputy Assistant Director for Continuous Vetting the incumbent serves as a Supervisory Personnel Security Specialist providing expertise related to...

  • Vendor Auditor

    2 weeks ago

    Wilmington, North Carolina, United States Johns Hopkins Medicine Full time

    Who you are:As the Vendor Auditor for Johns Hopkins Health Plans ("JHHP"), your in-depth knowledge of auditing, claims, and medical policy helps ensure that our vendors are performing to policy and regulations. Not only will you lead audits, you will also report out to the oversight committees and lead in audits performed by regulatory and accreditation...

  • Security Analyst III

    7 days ago

    Wilmington, North Carolina, United States Elevance Health Full time

    Security Analyst III Location: This position will work a hybrid model (remote & office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. Preferred Location: Hanover, MD. A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers...

  • Director, Product Integration

    7 days ago

    Wilmington, North Carolina, United States Novartis Full time

    SummaryThe ideal location for this role is East Hanover, NJ but remote work may be possible (there may be some exceptions based on legal entity registration). Please note that this role would not provide relocation as a result. If associate is remote, all home office expenses and any travel/lodging to specific to the East Hanover, NJ office for periodic live...

  • Sr. Brand Manager, CLIF Bar

    3 days ago

    Wilmington, North Carolina, United States Mondelēz International Full time

    Job DescriptionAre You Ready to Make It Happen at Mondelēz International?Join our Mission to Lead the Future of Snacking. Make It With Pride. Mission: Working with cross-functional global and regional teams, you support the CLIF Bar portfolio strategy that aligns with the category vision to drive sustainable brand growth and to deliver business objectives....