See more Collapse

Senior Regulatory Implementation

1 month ago

Providence, United States Highmark Health Full time

Company :

Highmark Health Job Description :

JOB SUMMARY 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 removing 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 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 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 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. written and verbal communication skills for diverse audiences (senior management, board, peer, and team) Capacity to think analytically, interpret information / observations, apply judgment and make effective, strategic decisions

#J-18808-Ljbffr

We have other current jobs related to this field that you can find below

  • Senior Manager, Regulatory Operations

    3 weeks ago

    Providence, United States Sumitomo Pharma Full time

    Sumitomo Pharma Senior Manager, Regulatory Operations Providence, Rhode Island Apply Now Sumitomo Pharma Co., Ltd. is a global pharmaceutical company based in Japan with key operations in the U.S. (Sumitomo Pharma America, Inc.), Canada (Sumitomo Pharma Canada, Inc.) and Europe (Sumitomo Pharma Switzerland GmbH) focused on addressing patient needs in...

  • Sr. Analyst, Implementation

    2 weeks ago

    Providence, United States Accuity Full time

    Job Type: Full-time Description I. POSITION SUMMARY: The Senior Analyst will assist the Director of Implementation (DOI) and EVP Operations with coordination of activities associated with the onboarding and implementation of new client partnerships with Accuity. Provide a superior client implementation experience by facilitating frictionless interactions...

  • Sr. Analyst, Implementation

    2 weeks ago

    Providence, United States Accuity Full time

    Job Type Full-time Description I. POSITION SUMMARY: The Senior Analyst will assist the Director of Implementation (DOI) and EVP Operations with coordination of activities associated with the onboarding and implementation of new client partnerships with Accuity. Provide a superior client implementation experience by facilitating frictionless interactions...

  • Senior Director, RWD Analytics and Innovation

    3 weeks ago

    Providence, United States Norstella Full time

    Senior Director, RWD Analytics and Innovation Company: Citeline Location: Remote, United States Date Posted: Jul 4, 2024 Employment Type: Full Time Job ID: R-408 Description Citeline is one of the world's leading providers of data and intelligence on clinical trials, drug treatments, medical devices and what's new in the regulatory and commercial landscape....

  • Credit Review Senior Portfolio Manager

    4 weeks ago

    Providence, United States Bank of America Full time

    Bank of America Credit Review Senior Portfolio Manager - Providence, Rhode Island Job Description: At Bank of America, we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities, and shareholders every...

  • Senior Financial Analyst

    2 months ago

    Providence, United States TALENT Software Services Full time

    Senior Financial AnalystJob Summary: Talent Software Services is in search of a Senior Financial Analyst for a contract position in Providence, RIThe opportunity will be one year with a strong chance for a long-term extension.Primary Responsibilities/Accountabilities: This role is primarily responsible for the financial tracking and reconciliation of...

  • Senior Director of Human Resources

    3 months ago

    Providence, United States Care New England Full time

    Job DescriptionJob DescriptionThis role is for direct support to Women & Infants Hospital in Providence, RI.Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation’s leading specialty hospitals for women and newborns. A major teaching affiliate of the Warren Alpert Medical School of Brown University for obstetrics,...

  • Audit Senior

    3 weeks ago

    Providence, United States Spartan Placements LLC Full time

    Audit SeniorResponsibilities: Conduct audit, review, and compilation procedures including testing of controls, substantive testing, and analytical procedures, to evaluate the accuracy and completeness of financial information. Coordinate day-to-day duties, including planning, fieldwork, and wrap-up, ensuring seamless execution. Demonstrate a deep...

  • Senior Director of Human Resource

    2 months ago

    Providence, United States Care New England Full time

    Job DescriptionJob DescriptionThis position is for direct support of the Care New Medical GroupThe Care New England Medical Group is a member of Care New England health system. With more than 500 physicians and advanced practitioners, and 1,200 total team members, Care New England Medical Group (CNEMG) offers primary care and specialty services in offices...

  • Audit Senior

    1 month ago

    Providence, United States Spartan Placements, LLC Full time

    Job DescriptionJob DescriptionAudit SeniorResponsibilities: Conduct audit, review, and compilation procedures including testing of controls, substantive testing, and analytical procedures, to evaluate the accuracy and completeness of financial information.Coordinate day-to-day duties, including planning, fieldwork, and wrap-up, ensuring seamless...

  • Director, Global Regulatory Affairs, Precision Medicine

    3 months ago

    Upper Providence Township, United States 1925 GlaxoSmithKline LLC Full time

    Purpose Ensure the development of appropriate Precision Medicine and Digital Health regulatory strategy(s) and their execution for assigned precision medicine and digital health asset(s) supporting across the GSK therapeutic portfolio. This goal must be achieved both as a component of an overall global regulatory approach and ensure compliance with both...

  • Senior Underwriter and Risk Analyst

    2 months ago

    Providence, United States Qualpay Full time

    Qualpay is a modern, cloud-based fully-integrated payments platform, taking the complexity out of payment transactions, making it easier than ever to process payments in all the ways consumers make purchases today. Our reporting intelligence (RI) and data analytics allow our businesses and partners to manage their payment finances quickly and efficiently,...

  • Senior Project Manager

    3 weeks ago

    Providence, United States WiredHive Full time

    Looking for candidates with 5+years of experience as a Senior Project Manager or related Project Management role. Must have solid experience managing projects related to software or system implementations and migrations. Solid knowledge/experience with the SDLC and the Agile/Scrum methodology would also be needed. Prior experience with vendor management and...

  • Senior Project Manager

    3 weeks ago

    Providence, United States WiredHive Full time

    Looking for candidates with 5+years of experience as a Senior Project Manager or related Project Management role. Must have solid experience managing projects related to software or system implementations and migrations. Solid knowledge/experience with the SDLC and the Agile/Scrum methodology would also be needed. Prior experience with vendor management and...

  • Senior accounting manager

    2 days ago

    Providence, United States Ryder Full time

    Preferred South Florida or Houston, TX area SUMMARY The Accounting Manager position reports directly to the Sr Director of Construction, Building Maintenance (BM) and Fuel Ops and is responsible for managing a team that provides accounting and financial support/analysis. The role will support four groups: Ryder Fuel Services (RFS), Real Estate (RE),...

  • Category Manager

    3 months ago

    Providence, United States PPL Services Corporation Full time

    Responsibilities This position may be hired at the Intermediate Category Manager or Senior Category Manager level and additional responsibilities may be included. Develop negotiation strategies and company positions on complex (multi-million dollar) contracts, work with Office of General Counsel to identify and incorporate appropriate levels of...

  • Senior Project Manager

    2 months ago

    Providence, United States HCH ENTERPRISES LLC Full time

    Job DescriptionJob DescriptionHCH Enterprises, LLC is seeking a Senior Project Manager. This is a full-time position with HCH Enterprises, LLC and a contract position with the state of Rhode Island. The Senior Project Manager will assist in the implementation of a new Business Registration platform. The Project Manager will be expected to or have experience...

  • Senior Project Manager

    2 months ago

    Providence, United States HCH ENTERPRISES LLC Full time

    Job DescriptionJob DescriptionHCH Enterprises, LLC is seeking a Senior Project Manager. This is a full-time position with HCH Enterprises, LLC and a contract position with the state of Rhode Island. The Senior Project Manager will assist in the implementation of a new Business Registration platform. The Project Manager will be expected to or have experience...

  • Senior Manager, Special Events

    3 weeks ago

    Providence, United States Hilton Full time

    Hilton Senior Manager, Special Events ***The location for this position is virtual/remote*** As a Senior Manager, Special Events, reporting to the Senior Director, Special Events, you will focus on developing the strategy and leading the project management and planning for internal Hilton conferences. You will work with Executive partners and business...

  • Human Resources Business Partner

    2 months ago

    Providence, United States Benchmark Senior Living Full time

    Benchmark Senior Living seeks an Human Resources Business Partner to join our Human Resources team. This key role will deliver Human Resource strategies that support the organizations goals, initiatives and priorities. The Human Resources Business Partner will have accountability to an assigned division comprising of 10-12 locations within MA/RI and will...