Highmark · 1 month ago
Senior Compliance Analyst
Highmark Inc. is a healthcare company seeking a Senior Compliance Analyst to partner with business units in ensuring compliance with various rules and regulations. The role involves monitoring regulatory changes, providing consultation, and overseeing compliance-related processes.
Health CareHealth InsuranceInsuranceWellness
Responsibilities
Manage and coordinate compliance related processes
Monitor governance and compliance of rules, regulations, policies, and procedures and assist with appropriate audits, as applicable. Contacts may include legislators, consumers, special interest groups, advocacy agencies, CMS, state Medicare/Medicaid administrators, and other regulatory bodies such as DPW
Ensure or participate in ensuring that systems are updated and accurate for compliance
Responsible for understanding and applying accreditation and regulatory requirements. May support Regulatory Compliance department to ensure all state renewals, applications, and annual reports are completed accurately and timely
Depending on department may be responsible for one of the following the delegation oversight of subcontractors when applicable to ensure compliance with health plan standards and policies and regulatory bodies; performing and providing oversight of the care management delegation functions of multiple vendors through review of annual assessments, monthly performance reporting and analysis of reports to ensure adherence to regulatory and accreditation standards
Other duties as assigned or requested
Qualification
Required
Bachelor's Degree or relevant experience and/or education as determined by the company in lieu of Bachelor's degree
5 years of relevant, progressive experience in the area of specialization
Strong written and oral communication skills
Strong customer orientation with excellent interpersonal skills, including interview techniques, good judgment, initiative, and discretion in confidential or sensitive matters
Self-starter with the ability to work under pressure independently and as part of a team
Superior decision-making abilities under a variety of circumstances and creative thinking and effective risk mitigation abilities
Strong process improvement and project management skills
Strong analytical ability
Demonstrated ability to effectively interact with all levels within the organization
Proficiency with Microsoft Office software programs and database query tools, and other Internet and Intranet applications and databases
Preferred
Master's Degree
Experience in one or more of the following healthcare operations, compliance, auditing, investigations, regulatory accreditation, process improvement, project management and/or managed care operations
Company
Highmark
Highmark provides health insurance plans for individuals and businesses.
Funding
Current Stage
Late StageTotal Funding
$27.3M2018-04-06Grant· $25M
2014-08-07Grant· $2.3M
Leadership Team
Recent News
2025-12-11
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