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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.
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
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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