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Senior Regulatory Implementation

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Bismarck, United States Highmark Health Full time

Highmark Health Senior Regulatory Implementation & Assurance Analyst - Bismarck, North Dakota

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. Support all external audits of the organization, including ensuring appropriate agreements are in place before the release of any information. Standardize documentation and tracking of audits, market conduct exams, regulatory reviews, and external accreditation assessments of the organization. Standardize and expand internal and external risk intake processes 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. Leverage analytics programs, decision support systems, and standards 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 a Bachelor's degree. Preferred: Master's degree in a related field. EXPERIENCE Required: 5 years of interacting with regulators, auditors, and/or oversight bodies. Preferred: None. LICENSES or CERTIFICATIONS Required: None. Preferred: Certified Public Accountant (CPA), Certified Information Systems Auditor (CISA), Juris Doctor (JD), CHC (Healthcare Compliance Certification). SKILLS Demonstrate knowledge of business and technology processes, risk and control frameworks, and assessment methodologies, particularly as applied to healthcare 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. Strong written and verbal communication skills for diverse audiences. Strong relationship building skills and ability to influence in a matrixed organization. Capacity to think analytically, interpret information, apply judgment, and make effective decisions. PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS Position Type: Office-based. Teaches/trains others regularly: Frequently. Travel regularly from the office to various work sites: Rarely. Works primarily out-of-the office selling products/services: Never. Physical work site required: Yes. Lifting: up to 10 pounds - Constantly, 10 to 25 pounds - Occasionally, 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. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. Pay Range Minimum: $67,500.00. Pay Range Maximum: $124,800.00. 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.

Highmark Health and its affiliates prohibit discrimination and take affirmative action to employ and advance 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. For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org. California Consumer Privacy Act Employees, Contractors, and Applicants Notice.

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