Lead Risk and Compliance Analyst

Company :

Highmark Health

Job Description : 

JOB SUMMARY

This job works collaboratively to support 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 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

• Provide input and consultation on risk and assurance reporting, along with terms and conditions in supplier contracts.  Collaborates and consults with other areas (e.g., Procurement, Privacy, Information Security, Legal) throughout the compliance/contract lifecycle along with internal business and contract administration partners.  Provide timely feedback to business areas.

• Interpret inherent risk assessment results and develops third party and overall assurance plans to address relevant risk areas and to ensure proper controls are implemented.  Accountable for the review and interpretation information provided by third parties and performs qualitative and quantitative impact assessments; conducts additional information gathering and risk assessments with suppliers as-needed; document and report results.  Review draft reports and other management reporting deliverables prior to the Enterprise Director and Vice President.  Oversee and review all work prepared by less experienced team members to ensure audit quality standards are consistently met in all forms of documentation.

• Oversee the delivery and timely completion of risk questionnaires and other risk assessments and leads impact assessment activates.  Lead team to ensure  compliance requirements are met across the Enterprise.  Train and mentor team members on multi-faceted relationships, platform customer dependencies, and interpretation of complex contract agreements.

• Interprets complex data flow/ information sharing activities and information safeguards into simplified and high-level terminology and/or process/data flows.  Maintain Enterprise reporting dashboards in RSA Archer applications in order to keep information complete, accurate, and current.  Prepares and assists with the delivery of reports to management. 

• Maintain and review updates made to profiles, engagements, assessments, contracts, and other third party information in the RSA Archer, including periodic or automated refresh of supplier data from ancillary systems.

• Interface with business areas, technical staff, project teams, and third parties to lead and execute cross-functional risk assurance projects.  Provide consultation and direction throughout, evaluate risks relative to new or existing programs and initiatives that support the Enterprise's strategic direction, core operations, etc.

• Responsible for ensuring departmental desk-level procedures, risk assessment methodology, assessment procedures, questionnaires, training, etc. are updated periodically and is accountable for monitoring compliance with departmental metrics, internal control activities, contractual obligations, regulatory requirements, and responding to customer inquiries / audits.  Build and maintain strong working relationships with all Enterprise companies to support the management of risks across multiple departments.

• Other duties as assigned or requested.

EDUCATION

Required

• Bachelor's 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 Bachelor's degree

Preferred

• Master's Degree in Accounting, Finance, Business Administration/Management, Information Technology, Pre-Law, or related field

EXPERIENCE

Required

• 7 years in Audit and Compliance

To Include:

• 5 years of Business Process Design

• 3 years in Project Management

Preferred

• None

LICENSES or CERTIFICATIONS

Required

• None

Preferred (any of the following)

• Certified Public Accountant (CPA)

• Certified Information Systems Auditor (CISA)

• Certified Information Privacy Professional (CIPP)

• Certified Information Systems Security Professional (CISSP)

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

Occasionally

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 times.  In 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 Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s 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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