Manager Risk & Compliance Management

Company :

Job Description :

JOB SUMMARY

This job is responsible for the day-to-day direction of all risk and compliance assessment activities of Highmark Health across a broad range of frameworks including NIST HITRUST PCI HIPAA SOC MAR CMS JCAHO etc. The incumbent will partner with the organizational risk and business partners the technology organization and global delivery teams to meet Highmark Healths 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

• Perform management responsibilities to include but are not limited to: involved in hiring and termination decisions coaching and development rewards and recognition performance management and staff productivity. Plan organize staff direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.

• Establishes the appropriate methodology to be used and procedures to be performed for third-party risk technology operational compliance and security programs across a broad range of frameworks including NIST HITRUST PCI HIPAA SOC MAR CMS JCAHO etc. This includes establishing necessary statistical sampling and utilizing various auditing methodologies.

• Coordinates and manage audits of departments across the enterprise to ensure compliance with policies schedule scope and accuracy with the latest laws and regulations accuracy and completeness business unit compliance program training and communications delivery.

• Partners with functional subject matter experts around the organization develops annual plan to address third-party strategic operational security reputational and financial risks for the Organizations family of companies.

• Establishes and monitoris Key Performance Indicators (KPIs) to ensure risk assessments are completed in accordance with Service Level Agreements privacy-security policies contractual obligations.

• Manages program to perform on-site third party audits regulatory reviews vendor risk reviews and validates necessary remediations to ensure alignment to relevant compliance guidelines.

• Negotiates on behalf of the organization in third-party regulatory and/or compliance engagements to ensure appropriate security audit regulatory and operational risk terms are appropriately addressed. Interact with vendor and business unit personnel at all levels and effectively communicate risks expectations and alternative strategies to mitigate the Organizations concerns over security audit and risk provisions.

• Other duties as assigned or requested.

EDUCATION

• Bachelors Degree in Accounting Finance Business Administration/Management Information Technology Pre-Law or related field

Substitutions

• 6 years of related and progressive experience in lieu of Bachelors degree

Preferred

• Masters Degree in Accounting Finance Business Administration/Management Information Technology Pre-Law or related field

EXPERIENCE

• 5 years of interaction with regulators auditors and oversight bodies

To Include:

• 3 years in a leadership role preferably in an Audit or Compliance discipline in a Healthcare or Healthcare related industry

• 3 years overseeing privacy risk audit and/or compliance teams

Preferred

• 3 years with contract negotiations

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• Certified Public Account (CPA)

• Certified Information Security Auditor (CISA)

• Certified Information Privacy Professional (CIPP)

• Certified Information Systems Security Professional (CISSP)

• Certified in Healthcare Compliance (CHC)

• Certified Internal Auditor (CIA)

SKILLS

• Demonstrate expert 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 assessments of vendors

• 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.

• Developed leadership qualities with an ability to motivate and inspire a group of individuals to achieve superior results.

• High 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

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 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 connection with this all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Companys Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore it is every employees responsibility to comply with the companys Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws rules and regulations as well as company policies and training requirements.

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 any category protected by applicable federal state or local law.

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