What are the responsibilities and job description for the Clinical Quality & Regulatory Specialist position at Highmark?
Highmark Inc., an independent licensee of the Blue Cross Blue Shield Association, is one of the largest affiliated organizations, serving approximately 7.1 million members across Pennsylvania, Delaware, West Virginia, and western and northeastern New York. It operates through multiple region-specific entities under the Highmark Blue Cross Blue Shield brand. As part of Highmark Health, the organization is committed to delivering exceptional healthcare solutions and fostering healthier communities through inclusive and innovative practices.
This is a full-time hybrid role for a Clinical Quality & Regulatory Specialist based in Pittsburgh, PA. The specialist will be responsible for overseeing and implementing clinical quality initiatives, staying up-to-date with regulatory standards, conducting research, and ensuring compliance with healthcare policies. The role requires collaboration with team members and external stakeholders, providing training, and performing quality improvement assessments. Some work-from-home flexibility is available.
- Strong Communication and interpersonal skills with the ability to collaborate effectively with a team
- Knowledge and experience in Medicine and Clinical Research
- Proficiency in conducting Research and analysis to support quality and regulatory initiatives
- Experience in Training healthcare professionals and stakeholders
- Ability to multitask and manage priorities effectively
- Familiarity with healthcare quality measures and regulatory compliance standards is preferred
- Bachelor’s degree in a healthcare-related field is preferred
