Regulatory Implementation and Assurance Analyst - Audit Oversight

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Audit & Compliance Regulatory Implementation and Assurance Analyst - Audit Oversight

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Regulatory Implementation and Assurance Analyst - Audit Oversight

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Pittsburgh PA 15222 FAP 5th Avenue Place Company: Highmark Inc.

Job Description

JOB SUMMARY This job is responsible for supporting the work of the department projects and initiatives related to the regulatory intake implementation and assurance 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 Senior Analyst and Lead analyst to support their work 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

• Take part in 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:
• Appropriate agreements are in place before the release of any information.
• The release of information is in accordance with applicable laws and organizational policies.
• Information provided to the auditors is complete and accurate.
• Chain of custody is maintained.
• 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 remove 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.
• 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 Required:

• Bachelors 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 Bachelors degree.

Preferred:

• None

EXPERIENCE Required:

• 3 years of interacting with regulators, auditors, and/or oversight bodies.
• 3 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 Required:

• None

Preferred:

• Any of the following:
• Certified Public Accountant (CPA)
• Certified Information Systems Auditor (CISA)

SKILLS

• 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, procurement, and completing risk-based assessments.
• Strong written and verbal communication skills for diverse audiences (senior management, board, peer, and team).
• Demonstrates relationship building skills and ability to influence with and without authority in a matrixed organization.
• 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 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 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.

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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Job Details

• Job category: Audit & Compliance
• Position Type: Full Time
• Posted: 03/25/2026
• Locations: Pittsburgh PA 15222 FAP 5th Avenue Place
• Line of Business: Entity
• Recruiter: Hiring Manager
• Experience Level: Job Family
• Regulatory Compliance-HM
• Req ID: J278538

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Highmark Health is an independent licensee of the Blue Cross Blue Shield Association.

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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