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Senior Regulatory Implementation & Assurance Analyst

Highmark Health

Greater London

On-site

GBP 45,000 - 85,000

7 days ago
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Job summary

An established industry player is seeking a proactive leader to manage risk case management initiatives. This role involves leading large projects, ensuring compliance with various regulatory frameworks, and collaborating with global teams to achieve strategic objectives. The ideal candidate will possess strong analytical and communication skills, with a proven track record of managing complex regulatory requirements in a healthcare setting. Join a forward-thinking organization that values innovation and teamwork, where your contributions will directly impact the quality of service and compliance standards. If you're ready to take on a challenging role that makes a difference, this opportunity is for you.

Qualifications

  • 5+ years of experience interacting with regulators and auditors.
  • Strong knowledge of risk and control frameworks in healthcare.

Responsibilities

  • Lead large team projects involving global specialists and regulatory compliance.
  • Standardize documentation and tracking of audits and regulatory reviews.

Skills

Risk and control frameworks

Regulatory guidelines

Project planning

Decision making

Communication skills

Analytical thinking

Relationship building

Education

Bachelor's degree in Accounting, Finance, Business Administration, IT, or related field

Master's degree in Accounting, Finance, Business Administration, IT, or related field

6 years of related experience in lieu of Bachelor's degree

Job description

This job is responsible for leading large projects and initiatives related to the risk case management and intake activities of Highmark Health in support of a broad range of frameworks and oversight bodies including NIST, HITRUST, PCI, HIPAA, SOC, MAR, CMS, JCAHO, NCQA, the BCBSA, etc. The incumbent will partner with the organizational risk and business partners, the technology organization, and global delivery teams to meet Highmark Health’s mission requirements in a manner consistent with the enterprise risk appetite. The incumbent must have a proactive mindset and approach, and feel comfortable working in a highly matrixed environment.

ESSENTIAL RESPONSIBILITIES

  • Lead large team projects or initiatives involving a global team of specialists. Coordinate with impacted departments to identify necessary changes to policies, procedures, processes, and technology based on the identification of legislative, regulatory, sub-regulatory, and licensing / accreditation requirements from the Regulatory Guidance team. Translate and communicate compliance requirements into business and technical requirements for impacted stakeholders and systems. Provide regular, executive summaries / abstracts to Risk Partners, Business Unit leadership, and / or the Audit Committee of the Board of Directors as required.
  • Create and execute complex regulatory implementation strategies for assigned legislative, regulatory, sub-regulatory, and licensing / accreditation requirements across multiple jurisdictions, including assessments of the regulatory impact of changes to people, processes, and technologies deployed across the enterprise.
  • Support all external audits of the organization, including ensuring that a) appropriate agreements are in place before the release of any information, b) the release of information is in accordance with applicable laws and organizational policies, c) information provided to the auditors is complete and accurate, d) chain of custody is maintained, and e) disruption to the daily operations of the Company is minimized.
  • Standardize documentation and tracking of audits, market conduct exams, regulatory reviews, and external accreditation assessments of the organization. During an audit, engage senior Business Unit leadership and remove barriers for outside parties. Prepare and / or provide status reporting to Risk Partners, accountable management, and the Audit Committee of the Board of Directors as necessary.
  • Standardize and expand internal and external risk intake (hotlines, inboxes, self-service, inquiries, vendor pipeline, incident & problem management systems, strategic initiative portfolio, etc.), and provide a streamlined, consistent point of entry for risk tracking, assessment, treatment, and monitoring for all of Highmark Health.
  • Implement policies and procedures to facilitate a consistent, high quality, confidential, and compliant service experience, including establishing service levels and requirements for the department and developing and implementing methods to record, assess, and analyze risk intake.
  • Leverage analytics programs, decision support systems, and standards that apply to complex information sets in order to make logical and supported risk & regulatory implementation recommendations.
  • Other duties as assigned or requested.

EDUCATION

Required

Bachelor's degree in Accounting, Finance, Business Administration / Management, Information Technology, Pre-Law, Computer, Information Science, or related field

Substitutions

6 years of related and progressive experience in lieu of Bachelor's degree

Preferred

Master's degree in Accounting, Finance, Business Administration / Management, Information Technology, Pre-Law, Computer, Information Science, or related field

EXPERIENCE

Required

5 years of interacting with regulators, auditors, and / or oversight bodies

5 years of increasing accountability and / or progressive role, preferably in an audit or compliance discipline in a healthcare or healthcare related industry

Preferred

None

LICENSES or CERTIFICATIONS

Required

None

Preferred (any of the following)

Certified Public Accountant (CPA)

Certified Information Systems Auditor (CISA)

Juris Doctor (JD)

SKILLS

Demonstrate knowledge of business and technology processes, risk and control frameworks, and assessment methodologies, particularly as applied to healthcare (payer and provider) business processes

Knowledge of relevant regulatory guidelines, vendor management, sourcing and procurement, and completing risk-based assessments

Excellent resource and project planning capabilities, decision making skills, history of results-oriented delivery, and effective team building across a cross-campus and diverse team of management and staff

Strong written and verbal communication skills for diverse audiences (senior management, board, peer, and team)

Strong relationship building skills and ability to influence with and without authority in a matrixed organization.

Capacity to think analytically, interpret information / observations, apply judgment and make effective, strategic decisions

Language (Other than English) :

None

Travel Requirement : 0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type: Office-based

Teaches / trains others regularly: Frequently

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

Lifting : up to 10 pounds: Constantly

Lifting : 10 to 25 pounds: Occasionally

Lifting : 25 to 50 pounds: Rarely

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 their race, color, age, religion, sex, national origin, sexual orientation / gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation / gender identity, protected veteran status or disability.

EEO is The Law

Equal Opportunity Employer Minorities / Women / Protected Veterans / Disabled / Sexual Orientation / Gender Identity

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