Job Description

Job Title: Senior Director, Regulatory Compliance/Licensure
Job ID: 09464910
Status: Full-Time
Regular/Temporary: Management
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: Compliance & Ethics
Location: 600 Grant St, Pittsburgh PA 15219

Description

Purpose:

The Sr. Director, Regulatory Compliance reports to the Associate VP, of Corporate Compliance & Ethics and strategically leads the development, implementation and management of a robust and effective Regulatory Compliance Program which includes licensure application process for UPMC's large and growing Insurance Services Division. This position ensures strong regulatory review, judgment and interpretations along with effective compliance communication to the organization. This is an exciting opportunity for a highly experienced functional expert to lead the vision, processes and tools for an effective regulatory program.



Responsibilities:
  • Assist and facilitate improvement of regulatory compliance program and maturity level
  • Implement and execute effective monitoring, tracking and reporting requirement to verify success of the regulatory program, as measured by assessments and metric based analysis.
  • Track record of successful staff management.
  • Build, improve and drive consistency of regulatory objectives, processes and tools.
  • Partner with business and operational leaders, cross functionally and collaboratively, to develop a structured coordinated and effective regulatory framework for review, interpretation and communication
  • Develop and deliver clear, effective and timely regulatory communication and updates for compliance committees, senior management and/or the Board, regarding regulatory effectiveness, initiatives and issues, including all relevant metrics, dashboards and information.
  • Performs in accordance with system wide competencies/behaviors
  • Performs other duties as assigned.
  • Keep current with regulatory standards and requirements, including all relevant laws, rules and industry standards and company practices.
  • Build and maintain strong and effective relationships with all relevant internal and external stakeholders, including federal and state regulatory entities, legal, actuary, product administration, quality assurance and FWA among others.
  • Enhance effective regulatory training program for end users to properly educate employees and business partners regarding regulatory requirements and responsibilities.
  • Partners with product compliance areas along with Work Partners and Community Care.

Qualifications

  • Bachelor's degree required, Master’s degree or JD preferred
  • Minimum of eight years of substantive regulatory review with increasingly progressive responsibility
  • Functional subject matter expertise in enhancing a large heavily regulated compliance program
  • Minimum of five years of work experience in a managerial/leadership role (i.e., managing a team, either directly or indirectly)
  • Proven ability to effectively and timely manage multiple initiatives and cross departmental projects
  • Strong acumen and understanding of healthcare, health insurance and managed care organizations strongly preferred, including all relevant business lines (commercial, FEHB, behavioral health, workers compensation, wellness etc.)
  • Requisite expertise and experience with regulatory standards and requirements and maintaining a comprehensive regulatory process
  • Strong verbal, written and auditory communication skills
  • Strong ability to synthesize complex regulations and clearly and concisely articulate the relevant points
  • Strong program and project management skills and experience required
  • Ability to influence at all levels of the organization, including executive management; the Board; regulators; employees; customers; partners and vendors
  • Highly consultative and partnership-oriented in approach
  • The role requires a leader who strikes the optimal balance between strategically navigating the regulatory requirements and business needs in a manner that’s nuanced and mutually reinforcing
  • Relevant trade associations memberships and certifications preferred
 


Licensure, Certifications, and Clearances:
Licensure/Certification:CHC certification preferred


UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $0 / hour

Union Position: No

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