Risk Partner

Company : Highmark Health Job Description : JOB SUMMARY This job is responsible for implementing, executing and maintaining the Compliance Program and its related policies to ensure the businesses act within the parameters of federal and state laws, regulations, and regulatory guidance. The incumbent is also responsible for the administration, interpretation, and enforcement of the Compliance Program including auditing/monitoring operational processes, conducting or overseeing compliance investigations, and ensuring that adequate training takes place under the Compliance Program. In this capacity, the individual is responsible for the collaborative and iterative execution of the risk and compliance plan for these entities across all areas in the enterprise risk taxonomy. Through matrixed leadership with Risk Operations and with support from Risk Enablement, the incumbent monitors and tracks the delivery of risk activities, including but not limited to, internal and external audit progress, recurring risk and compliance reporting, mandated training, investigations, and the impacts of new and changing laws, regulations, and contractual relationships. The incumbent must have extensive knowledge of the applicable federal and state rules as well as a solid working knowledge of managed care operations, compliance program structures, information security and audit methodologies. The incumbent must also have a foundational understanding of privacy regulations, including in-depth knowledge of HIPAA and possess the ability to perform a privacy risk assessment. The incumbent must have the highest level of integrity and ethics and demonstrate professional representation of the company. ESSENTIAL RESPONSIBILITIES Provides thought leadership and acts as an advisor to business leaders to ensure business decisions are made in alignment with the enterprise risk strategy / framework. Participates in and understands the business operations and strategy. Serves as a single point of contact for the business’ risks, compliance, privacy and security needs, and partners closely with legal counsel on all efforts. Works with Risk Operations and the Strategic Risk Partner to implement and maintain an effective compliance and risk management program for the supported entities. This includes, but is not limited to education and training requirements, reporting and intake protocols, monitoring and implementation of new or changing regulatory requirements, risk assessment and audit