Global Regulatory Implementation Lead

highmarkhealth; Pittsburgh (Allegheny County); On-site; USD 120,000 - 170,000; Full time

Job summary

Highmark Health is seeking a senior leader to drive large risk, compliance, and intake initiatives across multiple regulatory frameworks. You will partner with risk partners, business units, and technology teams to ensure compliant, efficient operations in a complex, matrixed environment.

The role requires strong communication with regulators and executives, and experience guiding enterprise-wide policy and process changes in healthcare settings.

Qualifications

• Bachelor's degree in Accounting, Finance, Business Administration/Management, Information Technology, Pre-Law, Computer, Information Science, or related field
• 6 years of related and progressive experience in lieu of Bachelor's degree
• Master's degree in Accounting, Finance, Business Administration/Management, Information Technology, Pre-Law, Computer, Information Science, or related field
• 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
• Certified Public Accountant (CPA)
• Certified Information Systems Auditor (CISA)
• Juris Doctor (JD)

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 regulatory requirements.
• Translate and communicate compliance requirements into business and technical requirements for impacted stakeholders and systems; provide executive summaries to Risk Partners and Audit Committee as required.
• Create and execute complex regulatory implementation strategies across multiple jurisdictions, assessing regulatory impact on people, processes, and technologies.
• Support external audits by ensuring proper agreements, lawful information release, complete and accurate data, chain of custody, and minimal daily disruption.
• Standardize documentation and tracking of audits, market conduct exams, regulatory reviews, and external accreditation assessments; provide status reporting to Risk Partners and leadership.
• Standardize and expand risk intake (hotlines, inboxes, self-service, inquiries, vendor pipeline, incident management) for Highmark Health.
• Implement policies to ensure a high quality, confidential, and compliant service experience with defined service levels.
• Use analytics and decision-support systems to make risk and regulatory implementation recommendations.

Skills

Regulatory compliance

Audit coordination

Regulatory guidance

Healthcare regulatory frameworks

Executive communication

Stakeholder management

Education

Bachelor's degree

Master's degree

Job description

Highmark Health is seeking a senior leader to drive large risk, compliance, and intake initiatives across multiple regulatory frameworks. You will partner with risk partners, business units, and technology teams to ensure compliant, efficient operations in a complex, matrixed environment.

The role requires strong communication with regulators and executives, and experience guiding enterprise-wide policy and process changes in healthcare settings.