Senior Compliance Analyst

Highmark Inc.

Job Title : Compliance Partner

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. Contacts may include legislators, consumers, special interest groups, advocacy agencies, CMS, state Medicare / Medicaid administrators, and other regulatory bodies such as DPW.
• Ensure or participate in ensuring that systems are updated and accurate for compliance.
• Responsible for understanding and applying accreditation and regulatory requirements. May support Regulatory Compliance department to ensure all state renewals, applications, and annual reports are completed accurately and timely.
• 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 :

Experience :

Preferred :

Knowledge, Skills and Abilities :

Language (Other than English) : None

Travel Requirement : 0% - 25%

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

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. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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