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Senior Risk & Compliance Analyst

Senior Risk & Compliance Analyst

Highmark HealthPittsburgh, PA, US
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Highmark Health Risk Assessment Specialist

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. This individual must have a proactive mindset and approach, and feel comfortable working in a highly matrixed environment.

Essential Responsibilities

  • Plan and conduct risk assessment activities according to the appropriate framework, including but not limited to NIST, HITRUST, PCI, HIPAA, SOC, MAR, CMS, JCAHO, in order to identify, assess, prioritize, evaluate and address financial, information security, privacy, and other areas of risk. Prepare draft reports and other management reporting deliverables. Review all work prepared by less experienced team members to ensure audit quality standards are consistently met in all forms of documentation.
  • Review and interpret inherent risk assessment results, engagement risks, and develop assurance plans (e.g., on-site audit, contract review, financials assessment, purchasing data analysis) to address relevant risk areas and to ensure proper controls are implemented. Accountable for the review and interpretation of authoritative guidance (including, but not limited to NIST, HITRUST, PCI, HIPAA, SOC, MAR, CMS, JCAHO reports) and performs qualitative and quantitative impact assessments based on physical, technical, and administrative safeguards as well as contractual requirements; conducts additional information gathering and risk assessments as-needed; documents and reports results.
  • Lead development of project plans to support risk assessment and decisioning in coordination with business owners and other stakeholders within task-based budgets. Collaborate and communicate with Information Security, Privacy, Procurement, Audit, Compliance, and other teams across the Enterprise to align risk management objectives, practices and procedures.
  • Interface with business areas, technical staff, project teams, and third parties to execute cross-functional risk assurance projects. Lead the communication of assessment results and findings with multiple stakeholder groups and provides consultation and direction throughout.
  • Interpret complex data flow / information sharing activities, customer integrations, and information safeguards into simplified and high-level terminology and / or process / data flows. Maintains risk management reporting dashboards in RSA Archer applications in order to keep information complete, accurate, and current. Prepare and assist with the delivery of risk assurance reports to management.
  • Ensure risk questionnaires and other risk assessments are distributed and completed on-time and prepares initial impact assessments. Ensure compliance requirements are met across the Enterprise. Assist in training and mentoring team members on multi-faceted engagements, platform customer dependencies, and interpretation of complex contract agreements.
  • Collaborate with lead in providing input and consultation on risk and assurance reporting. Collaborate and consult with other areas (e.g., Procurement, Privacy, Information Security, Legal) throughout the engagement lifecycle Assist in providing timely feedback on interpretations regarding authoritative guidance.
  • Proactively reviews updates made to departmental desk-level procedures, risk assessment methodology, assessment procedures, questionnaires, training, etc. and is responsible for monitoring compliance with departmental metrics, internal control activities, contractual obligations, regulatory requirements, and responding to customer inquiries / audits.
  • 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

  • 5 years in Audit and Compliance
  • 3 years of Business Process Design
  • 3 years of Project Management
  • Preferred

  • None
  • Licenses or Certifications

    Required

  • None
  • Preferred (any of the following)

  • Certified Public Accountant (CPA)
  • Certified Information Systems Analyst (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.
  • 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

    Travels 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.

    We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.

    For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

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