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Policy Manager Jobs in Raleigh, NC (NOW HIRING)

Red Lobster

Restaurant Manager

Raleigh, NC

$53K - $62K/yr

Here's more of what you'll get to do Driving sales and guest satisfaction Creating a FUN safe environment for team members to develop Ensuring compliance with all employment policies Managing ...

Red Lobster

Restaurant Manager

Raleigh, NC

$53K - $62K/yr

Ensuring compliance with all employment policies * Managing performance of team members, including conducting performance evaluations, training, coaching, and discipline * Selecting top talent to add ...

Red Lobster

Restaurant Manager

Raleigh, NC · On-site

$53K - $62K/yr

Ensuring compliance with all employment policies * Managing performance of team members, including conducting performance evaluations, training, coaching, and discipline * Selecting top talent to add ...

Red Lobster

Restaurant Manager

Raleigh, NC · On-site

$53K - $62K/yr

Ensuring compliance with all employment policies * Managing performance of team members, including conducting performance evaluations, training, coaching, and discipline * Selecting top talent to add ...

Genx Ventures LLC

Shift Manager

Morrisville, NC · On-site

$12 - $15/hr

Follows standard Potbelly operating policies and procedures with essential areas of focus including ... Manage back-of-the-house to ensure standards are met. * Ensure shop security and safety by ...

Genx Ventures LLC

Shift Manager

Morrisville, NC · On-site

$12 - $15/hr

Follows standard Potbelly operating policies and procedures with essential areas of focus including ... Manage back-of-the-house to ensure standards are met. * Ensure shop security and safety by ...

KOHLS

Store Manager

Cary, NC · On-site

Manage associate relations issues including performance management, and ensure associates follow company policies * Manage the training process for new hires on Kohl's culture, product knowledge ...

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Showing results 21-40

All JobsPolicy JobsPolicy Manager JobsPolicy Manager Jobs in Raleigh, NC

Policy Manager information

See Raleigh, NC salary details

$55.9K

$106.5K

$126.4K

How much do policy manager jobs pay per year?

As of Aug 13, 2026, the average yearly pay for policy manager in Raleigh, NC is $106,521.00, according to ZipRecruiter salary data. Most workers in this role earn between $105,000.00 and $113,200.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a policy manager, and why are they important?

To thrive as a Policy Manager, you need strong analytical abilities, policy research skills, and a relevant degree such as public policy, law, or political science. Familiarity with policy analysis tools, legislative tracking systems, and sometimes certifications in project management or public affairs are often required. Exceptional communication, stakeholder management, and negotiation skills help you effectively advocate for and implement policy initiatives. These skills are crucial for developing impactful policies, navigating complex regulatory environments, and ensuring successful stakeholder engagement.

What is the difference between Policy Manager vs Compliance Officer?

AspectPolicy ManagerCompliance Officer
CredentialsOften requires a degree in law, public policy, or related fields; certifications like CPCU or CIP are commonTypically holds degrees in law, business, or related areas; certifications such as CCEP or CRC are common
Work EnvironmentWorks within organizations to develop and manage policies across departmentsEnsures organizational adherence to laws and regulations, often conducting audits and training
Industry UsageUsed across various industries including finance, healthcare, and governmentPrimarily in regulated industries like finance, healthcare, and manufacturing

While both roles focus on organizational standards, Policy Managers develop and oversee internal policies, whereas Compliance Officers ensure adherence to external regulations. They often collaborate but serve distinct functions within organizations.

What are some common challenges faced by a policy manager when aligning internal policies with external regulations?

Policy Managers often encounter the challenge of keeping internal policies compliant with frequently changing external regulations and industry standards. This requires continuous monitoring of legislative updates and close collaboration with legal, compliance, and operational teams. Additionally, translating complex regulatory language into clear, actionable internal policies can be demanding, especially when managing stakeholder expectations and ensuring company-wide adherence. Developing effective communication and strong cross-functional relationships is essential for success in this role.
What are the most commonly searched types of Policy jobs in Raleigh, NC? The most popular types of Policy jobs in Raleigh, NC are:
What are popular job titles related to Policy Manager jobs in Raleigh, NC? For Policy Manager jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Policy Manager jobs in Raleigh, NC look for? The top searched job categories for Policy Manager jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Policy Manager jobs? Cities near Raleigh, NC with the most Policy Manager job openings:
Policy Manager jobs near you
Infographic showing various Policy Manager job openings in Raleigh, NC as of August 2026, with employment types broken down into 84% Full Time, 12% Part Time, and 4% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $106,514 per year, or $51.2 per hour.

Senior Manager, Medical and Clinical Claim Policy and Integration

Brighton Health Plan Solutions, LLC

Chapel Hill, NC • On-site

Full-time

Medical, Vision

Posted 13 days ago

Job description

About The Role
The Senior Manager of Medical and Clinical Claim Policy and Configuration is a senior level decision maker responsible for the content and management of Medical and Claim Policies. Also provides direction and support for system configurations as well as necessary operational assistance to ensure effective policy implementations. This individual will gain broad exposure and work closely with all business units including Medical Management, Network Management, Claims, Operations, IT, Sales and Account Management, and Legal.
*This is a remote role.
Primary Responsibilities
  • Review, update, evaluate and develop medical and clinical claims policies for Commercial medical insurance segment to promote quality, optimize utilization and cost to make them effective for the business.
  • Take responsibility and work closely with Healthcare Economics, Medical Management, Network Management, Claims, Operations, IT, Sales & Account Management, and Legal to implement policies designed to support the effective management of medical expenses and promote quality care.
  • Collaborate with IT and other departments on business and technical requirements involving policies.
  • Develop and maintain Prior Authorization list for Commercial business.
  • Manage Medical and Clinical Claim policy web content and publication.
  • Serve as the subject matter expert for Claims Editing Solution (CES) and lead initiatives involving medical and claim policy including but not limited to CES rules and configuration.
  • Prepares analyses and recommendations for medical policy updates and new code implementation for Medical Director review. Responsibilities include researching applicable CPT/HCPCS/ICD codes, benchmarking industry and payer practices, evaluating benefit and operational impacts, and providing recommendations for code handling, coverage determinations, and benefit integration.
  • Leads the digitization and maintenance of medical policies, including converting policies into electronic formats, configuring policy content within designated systems, ensuring version control and accuracy, and supporting ongoing updates to align with regulatory requirements, business needs, and operational workflows.
  • Maintains and updates JIVA automation code sets, rules, and configurations to support accurate claims processing, utilization management workflows, benefit administration, and medical policy implementation.
  • Work closely with Benefits team in configuration of new clients and working with High Dollar team for coding, PA and benefit questions
Essential Qualifications
  • Expert understanding of Medical Claims operations including medical insurance benefits, medical policy, claims policy, quality assurance, utilization review, and medical cost management.
  • Solid understanding of claim processing including pricing and code editing.
  • Strong organizational and planning skills to manage multiple priorities and meet required deadlines.
  • Good communicator, organized, and able to write clearly
  • Enjoys the challenges associated with decision support algorithms and the attention to detail it requires.
  • This job requires the ability to embed logic in narrative prose and be comfortable with numbers.
  • 5 years' experience in health care administration, managed care, or medical insurance field required
  • 2+ years' experience creating, writing, or managing clinical, claims, or healthcare technical policies and procedures is preferred.
  • Experience working with medical and claims policy reference sources such as CPT/HCPCS/ICD/DRG coding manuals, Specialty Society Guidelines, National Guidelines Clearinghouse materials, CMS and CMS Intermediary policies, and Commercial Health plans policies, among others.
  • Bachelors with an advanced or specialized degree in healthcare, public health, epidemiology, or health policy preferred (Public Health, Pharmacy, Allied Health Professional, Nursing etc.), certified medical coder preferred.
  • Familiarity working with state and federal mandates, and FDA and other regulatory requirements for medical devices, drugs and biologics.
  • Comfortable with Microsoft Word and Excel.

About
At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you'll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion and a sense of belonging at every level. Here, you'll be encouraged to bring your authentic self to work with all of your unique abilities.
Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today's healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today's challenges into tomorrow's solutions.
Come be a part of the Brightest Ideas in Healthcare™.
Company Mission
Transform the health plan experience - how health care is accessed and delivered - by bringing outstanding products and services to our partners.
Company Vision
Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways.
JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Brighton Health Plan Solutions in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All of our career opportunities are regularly published and updated brighonthps.com Careers section. If you have already provided your personal information, please report it to your local authorities. Any fraudulent activity should be reported to: [email protected]

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