Compliance Reporting Specialist - Hybrid

UPMC Health Plan is seeking a full-time Compliance Reporting Specialist to join our Compliance and Ethics department. This position follows a hybrid work model, with two days per week onsite at the U.S. Steel Tower in downtown Pittsburgh.

We're looking for a detail-oriented professional with a background in legal, compliance, regulatory affairs, or quality audit. The ideal candidate will be comfortable engaging with board members and collaborating across various levels of leadership.

The Compliance Reporting Specialist is primarily responsible for review of current regulatory requirements, and assisting with the preparation of quarterly and annual reports, according to the annual Regulatory Reporting Calendar for UPMC Health Plan in Pennsylvania, Ohio and West Virginia, and others as determined by leadership. The Compliance Reporting Specialist works closely with designated compliance staff to assist in aspects of regulatory compliance, and other related Compliance & Ethics functions including training for UPMC Insurance Services Division staff on topics that are managed by the Compliance Reporting Specialist.

Responsibilities:

• Responsible for the receipt, workflow, storage, and retrieval of all inquiries relating to regulatory reporting deadlines and requirements in a timely manner, as well as the creation and compliance with the Regulatory Reporting Calendar.

• Ensures priority inquiry files are maintained and submitted in accordance with government, regulatory and operational requirements

• Responsible for the timely collection and submission of Insurance Services Division board member bio-affidavits, including but not limited to, collaboration with the relevant stakeholders and background checks.

• Conflict of Interest review, validation, and follow up to necessary stakeholders to ensure proper documentation.

• Establishes knowledge of all regulatory requirements assigned to the Compliance Reporting Specialist and communicates pertinent findings to appropriate staff, for the collection and submission of reports.

• Develops and manages relationships with colleagues in a professional, independent manner.

• Presents on-going educational updates to meet business needs.

• Report on a weekly basis, status of all assignments, pertinent information obtaining during report week, and provide projections for upcoming week to CCEO Leadership.

• This position requires a Bachelor's degree or equivalent.

• Preference will be given to those with a Bachelors, however, those without a degree that have directly related experience will be considered.

• Three years of experience in the insurance industry or government management care programs are required.

• Background in legal, compliance, regulatory affairs, or quality audit highly preferred.

• Excellent written and oral communication skills and ability to critically review regulations, contract provisions and policies and procedures is required.

• Identifies, develops and participates in process improvement opportunities within the compliance role.

• Must have good organizational skills and proficiency in Microsoft Word and Excel.

• Must also possess the ability to learn new software as needed.

• Must be self-motivated, and capable of meeting stringent deadlines.Licensure, Certifications, and Clearances:UPMC is an Equal Opportunity Employer/Disability/Veteran