Vice President, Government Program Compliance

/Vice President, Government Program Compliance
Organization: UPMC Health Plan (UPMC HP)
City: Pittsburgh
State: PA
Country: USA

Witt/Kieffer is assisting UPMC Health Plan (UPMC HP) based in Pittsburgh, Pennsylvania in recruiting its new Vice President, Government Program Compliance (Vice President).

The Vice President strategically and operationally leads the development, implementation and management of a robust and effective set of Government Product Compliance Programs for UPMC’s large and growing Insurance Services Division. Reporting to the Senior Vice President, Chief Risk, Compliance & Ethics Officer, the Vice President will be responsible for overseeing and working with each Government Program Compliance leader and their team, (Medicare, Medicaid, Behavioral Health, Exchange and CHIP) to strategically ensure compliance with all relevant and applicable laws, regulations, and contractual agreements in a manner that continually supports the business and operational areas across the wide array of Government Program products and lines of businesses at UPMC Insurance Services. The Vice President will have an initial total staff of approximately 40 people with four direct reports. 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 twelve years broad-based and extensive Government Programs health insurance (payer) compliance and/or legal experience required. This includes Medicare, Medicaid, Duals, SNP, Exchange, CHIP, Long-Term Services & Supports, behavioral health, intellectual disabilities and/or other such Government-related health insurance programs, products and services.

Inquiries/questions/materials should be submitted via email to

Link to Apply: