6 compliance coordinator jobs found

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: The Office of Sponsored Research (OSR) provides centralized administrative services and oversight for clinical research programs, and activities include, but not limited to: Medicare Coverage Analysis and associated filings with the Center for Medicare and Medicaid, budgetary development, protocol review, contract and budget negotiations. The incumbent is responsible for negotiating and executing clinical trial agreements and preparing budgets based on study protocol optimizing reimbursement from Sponsors. In addition, incumbent will build and maintain the study within Clinical Trial Management System (CTMS) along with performing Medicare Coverage Analysis (MCA) to support billing compliance efforts. Assists and contributes with the development and maintenance of Office of Sponsored Research (OSR) policies and procedures. Participates and contributes in process improvement initiatives within OSR....

Company : HM Insurance Group Job Description : JOB SUMMARY This role provides critical sales account support for HM Insurance Groups' Stop Loss Business Unit, facilitating the seamless implementation and ongoing administration of group accounts. The incumbent will be instrumental in assisting the sales team by managing complex, stop loss sales cycle tasks and acting as a primary point of contact for resolving issues related to RFP intake, underwriting, account implementation, and ongoing group account service. This position requires significant expertise within the Stop Loss or employer benefits discipline and involves direct interaction with producers, clients, and sales representatives to ensure comprehensive workflow support on new business and renewal activities. The incumbent will also contribute to and manage small to medium projects within their assigned area. ESSENTIAL RESPONSIBILITIES Load and maintain group information and benefit files....

Company : Highmark Health Job Description : JOB SUMMARY This job performs financial and business related research and analysis such as the preparation of forecasts and/or analysis of financial reports, records and trends; develops and maintains spreadsheets and databases to facilitate analysis and reporting; and is responsible for conducting and documenting financial analysis projects. ESSENTIAL RESPONSIBILITIES Display effective communication skills. Coordinate with other departments, locations, and divisions. Communicate with other departments and/or outside agencies to resolve problems. Communicate with management at the Organization, subsidiaries, affiliates, other third parties, etc. as to project status and completion deadlines. Advise management of expected outcomes, and recommending ways to improve the outcomes. Conduct presentation to all levels of management in order to provide a summary of analysis regarding...

Company : Highmark Inc. Job Description : JOB SUMMARY This job provides expertise for standard to moderately complex problem solving and in-depth understanding of system functionality. The incumbent reviews significant amounts of information and analyzes processes to support business unit needs. May troubleshoot errors, conduct impact analyses, and/or solve data rejection. Performs business analyses in one or more operational areas. Identifies process gaps and recommends process improvements for efficiencies. May provide guidance to Associate level employees. ESSENTIAL RESPONSIBILITIES Intake operational objectives and gather information. May perform routine research and evaluate basic output requirements and formats. Communicate business operational requirements to internal groups responsible for developing/testing business requirements in various applications. Coordinate, monitor, and report on the progress of projects to ensure adherence to...

Company : Highmark Inc. Job Description : JOB SUMMARY This role operates in a hybrid model (T,W,TH) for employees residing within 50 miles of the corporate office. Work with Pharmacy Markets business owners, stakeholders and other management, as required, to achieve Pharmacy Markets growth objectives. Organize and coordinate Pharmacy Markets activities to focus on the successful delivery of desired results. Monitor and evaluate the progress, status and alignment of activities. Perform corrective action as needed to maintain the viability, relevance and timeliness of the work. Communicate regularly and effectively with customers regarding issues or concerns. Depending on the Pharmacy Markets business unit, may be responsible for one or more of the following: Perform research on projects and manage and lead projects to successfully meet business objectives. May manage all size projects (small, medium, large, enterprise). Analyzes data to determine business...

Company : Highmark Health Job Description : JOB SUMMARY 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...