Senior Compliance Analyst

Job Opportunity at Highmark Inc.

Job Summary : This job partners with business units to ensure compliance to rules, regulations, policies, and procedures of governmental, contractual, and / or corporate entities. Provide consultation and analytic support to assigned functional areas. Continuously monitors regulatory changes, legislative efforts, industry trends, and / or contract changes.

Essential Responsibilities

• Manage and coordinate compliance related processes.
• Monitor governance and compliance of rules, regulations, policies, and procedures and assist with appropriate audits, as applicable.
• Ensure or participate in ensuring that systems are updated and accurate for compliance.
• Responsible for understanding and applying accreditation and regulatory requirements.
• Depending on department may be responsible for one of the following : the delegation oversight of subcontractors when applicable to ensure compliance with health plan standards and policies and regulatory bodies; performing and providing oversight of the care management delegation functions of multiple vendors through review of annual assessments, monthly performance reporting and analysis of reports to ensure adherence to regulatory and accreditation standards.
• Other duties as assigned or requested.

Qualifications

Education : Bachelor's Degree or relevant experience and / or education as determined by the company in lieu of Bachelor's degree.

Experience : 5 years of relevant, progressive experience in the area of specialization.

Preferred : Master's Degree; Experience in one or more of the following : healthcare operations, compliance, auditing, investigations, regulatory accreditation, process improvement, project management and / or managed care operations.

Knowledge, Skills and Abilities

Physical, Mental Demands and Working Conditions

Position Type Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products / services (sales employees) Never Physical work site required Yes

Lifting : up to 10 pounds Constantly Lifting : 10 to 25 pounds Occasionally Lifting : 25 to 50 pounds Rarely

Disclaimer : The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

Pay Range Minimum : $50,200.00 Pay Range Maximum : $91,200.00 Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.