Senior Director, Commercial Compliance

/Senior Director, Commercial Compliance
Organization: UPMC Health Plan (UPMC HP)
City: Pittsburgh
State: PA
Country: USA
Description:

Witt/Kieffer is assisting UPMC Health Plan (UPMC HP) based in Pittsburgh, Pennsylvania in recruiting its new Senior Director, Commercial Compliance (Senior Director).

The Senior Director, who is responsible for building a new department, will strategically and operationally lead the development, implementation and management of a robust and effective Commercial Compliance Program for UPMC’s large and growing Insurance Services Division. This position strategically ensures compliance with all relevant and applicable laws, regulations, and contractual agreements in a manner that continually supports the business and operational areas. In addition, this position oversees the workers’ compensation and ancillary/third-party administrator (TPA) compliance programs and functions.

Reporting to the Senior Vice President, Chief Risk, Compliance & Ethics Officer, the Senior Director will provide overall direction through the strategic development and execution of a healthcare compliance program in support of the mission and strategic goals of UPMC Health Plan. This is an exciting opportunity to join a health plan that is among the fastest-growing in the nation and work closely with senior leadership in realizing its overall goals and objectives.

UPMC HP is part of the larger and diversified UPMC Insurance Services set of partner and affiliated companies, which itself is part of the broader UPMC Health System, a world-renowned integrated health care delivery and finance system. As part of an integrated health care delivery system, UPMC Insurance Services and Health Plan are committed to providing their members with access to high-quality and affordable health care. UPMC Health Plan partners with UPMC and non-UPMC network providers to deliver a combination of knowledge and expertise that provides the highest quality care at the most affordable price. Formed in 1996, UPMC HP now serves approximately 3.5 million members. The UPMC Insurance Services Division offers a full range of group health insurance, commercial, Exchange, Medicaid, Medicare, Special Needs, CHIP, behavioral health, employee assistance, ancillary and specialty, and workers’ compensation products and services.  UPMC HP’s local provider network includes UPMC as well as non-UPMC community providers, totaling more than 140 hospitals and more than 23,300 physicians throughout Pennsylvania and parts of Ohio, West Virginia, and Maryland. UPMC HP’s 2018 annual revenue will be approximately $9.5 billion with 2019 projected revenues to be approximately $11 billion.

The successful candidate must have a Bachelor’s degree while a Master’s Degree and/or JD is preferred. In addition, candidates must have an outstanding record of achievement with at least eight years of health plan commercial compliance insurance experience. The successful candidate will also be a transparent and collaborative leader, comfortable spearheading and supporting change in a complex environment. Prior in-house legal or compliance experience; commercial compliance experience and workers’ compensation and/or ancillary/third-party administrator compliance experience are preferred.

Inquiries/questions/materials should be submitted via email to UPMCCommercialCompliance@wittkieffer.com.

 

Contact: UPMCCommercialCompliance@wittkieffer.com
Link to Apply:
This website uses cookies and third party services. Settings Ok

Site Cookie Policy

Cookie Policy for Ethics.org

This is the Cookie Policy for Ethics.org, accessible from https://www.ethics.org/

What Are Cookies

As is common practice with almost all professional websites this site uses cookies, which are tiny files that are downloaded to your computer, to improve your experience. This page describes what information they gather, how we use it and why we sometimes need to store these cookies. We will also share how you can prevent these cookies from being stored however this may downgrade or 'break' certain elements of the sites functionality.

For more general information on cookies see the Wikipedia article on HTTP Cookies.

How We Use Cookies

We use cookies for a variety of reasons detailed below. Unfortunately in most cases there are no industry standard options for disabling cookies without completely disabling the functionality and features they add to this site. It is recommended that you leave on all cookies if you are not sure whether you need them or not in case they are used to provide a service that you use.

Disabling Cookies

You can prevent the setting of cookies by adjusting the settings on your browser (see your browser Help for how to do this). Be aware that disabling cookies will affect the functionality of this and many other websites that you visit. Disabling cookies will usually result in also disabling certain functionality and features of the this site. Therefore it is recommended that you do not disable cookies.

The Cookies We Set

  • Account related cookies

    If you create an account with us then we will use cookies for the management of the signup process and general administration. These cookies will usually be deleted when you log out however in some cases they may remain afterwards to remember your site preferences when logged out.

  • Login related cookies

    We use cookies when you are logged in so that we can remember this fact. This prevents you from having to log in every single time you visit a new page. These cookies are typically removed or cleared when you log out to ensure that you can only access restricted features and areas when logged in.

  • Forms related cookies

    When you submit data to through a form such as those found on contact pages or comment forms cookies may be set to remember your user details for future correspondence.

  • Site preferences cookies

    In order to provide you with a great experience on this site we provide the functionality to set your preferences for how this site runs when you use it. In order to remember your preferences we need to set cookies so that this information can be called whenever you interact with a page is affected by your preferences.

Third Party Cookies

In some special cases we also use cookies provided by trusted third parties. The following section details which third party cookies you might encounter through this site.

  • This site uses Google Analytics which is one of the most widespread and trusted analytics solution on the web for helping us to understand how you use the site and ways that we can improve your experience. These cookies may track things such as how long you spend on the site and the pages that you visit so we can continue to produce engaging content.

    For more information on Google Analytics cookies, see the official Google Analytics page.

  • Third party analytics are used to track and measure usage of this site so that we can continue to produce engaging content. These cookies may track things such as how long you spend on the site or pages you visit which helps us to understand how we can improve the site for you.

More Information

Hopefully that has clarified things for you and as was previously mentioned if there is something that you aren't sure whether you need or not it's usually safer to leave cookies enabled in case it does interact with one of the features you use on our site.

However if you are still looking for more information then you can contact us through one of our preferred contact methods:

  • Email: community@ethics.org