Job Description

Job Title: Administrator, Regulatory Compliance- Commercial
Job ID: 723516
Status: Full-Time
Regular/Temporary: Regular
Shift: Day Job
Facility: UPMC Health Plan
Department: HPLAN - Commercial Compliance
Location: 600 Grant St, Pittsburgh PA 15219


The Administrator, Commercial Compliance reports to the Sr. Director, Commercial Compliance. This position strategically ensures compliance with all relevant and applicable Commercial laws, regulations, contractual agreements, standards and requirements in a manner that continually supports the business and operational areas.


  • As requested by key UPMC-HP management staff, works on responses to RFPs and grant programs for government programs
  • Assists the Corporate Compliance Office with the Compliance Committee, Policy & Procedure Committee, Policy & Procedure Subcommittee and Compliance training.
  • Leads project teams for compliance.
  • Oversees preparation of quarterly and annual reports to PA DOH/PID and comparable reporting requirements for Ohio and West Virginia, lobby expense reporting and licensure renewals. Leads team for state/county expansions
  • Provides direct supervision of staff.
  • Reports on a weekly basis status of all assignments pertinent information obtained during report week. Provides projections for upcoming week.
  • Reviews drafts and/or drafts (as requested) policies and procedures from compliance perspective and maintains required Corporate policies and procedures
  • Updates key management staff of regulatory changes/developments and implications of new health care legislative initiatives on functional areas of UPMC Insurance Services Division.
  • Works with Senior Director of Compliance and designated departments to coordinate compliance monitoring
  • Works with UPMC-HP staff on review of proposed health care legislation and implementation schedules for newly enacted health care legislation and regulations


  • Bachelors degree required.
  • Masters degree and/or paralegal certificate preferred.
  • Previous management/supervisory experience preferred.
  • 5 years health insurance, government products, or regulatory review required.
  • Must have strong analytical and organizational skills, as well as problem-solving capabilities to verify that business plans and/or strategies do not place the company in violation of federal, state, or accreditation standards.
  • Excellent oral and written communication and computer skills.

    Licensure, Certifications, and Clearances:
    UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $30.89 to $52.76 / hour

Union Position: No

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