Top 2042 Regulatory specialist Jobs in Pennsylvania

RN, Regulatory Compliance Quality Specialist
Thomas Jefferson University and Hospitals —Philadelphia, PA
- Full-time
- Nursing
- RN License
- Hospital
- AD&D insurance
- Disability insurance
Benefits Verification Specialist
CVS Health —Pennsylvania
- $17.00 - $31.30 an hour
- Full-time
- Remote
- Microsoft Outlook
- Customer service
- Mid-level
- Health insurance
- Dental insurance
Senior Claim Benefit Specialist - Remote
CVS Health —Pennsylvania
- $18.50 - $42.35 an hour
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Mentoring
- Health insurance
- Dental insurance
8d
Behavior Analyst
Clarvida —Pottsville, PA
- $58 an hour
- Full-time
- LMFT
- Management
- Psychiatry
- Continuing education credits
- Mileage reimbursement
Quick Apply
Chiropractor
CarePath Injury Centers of Pennsylvania —Carlisle, PA
- $75,000 - $90,000 a year
- Full-time
- Mid-level
- Outpatient experience
- Clinic
- Paid holidays
- Health insurance
Quick Apply
Behavior Analyst - OPEN
Clarvida —Johnstown, PA
- $50 an hour
- Part-time
- LMFT
- Management
- Psychiatry
- Continuing education credits
- Mileage reimbursement
Quick Apply
13d
Behavior Analyst - OPEN
Clarvida —State College, PA
- $58 an hour
- Full-time
- LMFT
- Management
- Psychiatry
- Continuing education credits
- Mileage reimbursement
Quick Apply
13d
Behavior Analyst - Open
Clarvida —Saint Marys, PA
- $58 an hour
- Part-time
- LMFT
- Management
- Psychiatry
- Continuing education credits
- Mileage reimbursement
Quick Apply
13d
Behavior Analyst
Clarvida —Erie, PA
- $58 an hour
- Full-time
- LMFT
- Psychiatry
- Licensed Clinical Social Worker
- Mileage reimbursement
- Paid holidays
Quick Apply
Pharmacy Quality Improvement Specialist | Onsite - Pittsburgh
Blink Health —Pittsburgh, PA
- Rotating shift
- Mid-level
- Office
- Analysis skills
- Free parking
- Commuter assistance
Quick Apply
12d
Construction Safety Specialist
Compliance Management International —Olyphant, PA
- Overtime
- 6 years
- Construction site
- Mid-level
- Paid training
- Paid holidays
Quick Apply
13d
Direct Support Professional
Onewell Healthcare - Pennsylvania —Acme, PA
- $18 - $23 an hour
- Part-time
- Clean driving record
- Computer literacy
- HIPAA
- Mileage reimbursement
- Health savings account
Quick Apply
5d
Oral Surgeon
SALT Dental Partners —Newtown, PA
- $400,000 a year
- Full-time
- CPR Certification
- Dental office
- Surgery
ACT Mental Health Therapist/Specialist - $7,000 Hiring Bonus
Wesley Family Services —Greensburg, PA
- $44,000 - $46,000 a year
- Full-time
- Clean driving record
- Mid-level
- Master's degree
- Paid parental leave
- Paid holidays
Quick Apply
5d
Workers' Compensation Nurse Case Manager - RNs ONLY
Hoover Rehabilitation Services, Inc. —Edinboro, PA
- Full-time
- Nursing
- RN License
- Computer literacy
- Travel reimbursement
- Health insurance
Quick Apply
Commercial Loan Documentation Specialist
Firstrust Bank —Horsham, PA
- Full-time
- Hybrid work
- Office
- Business development
- In-person
Quick Apply
Special Education Director
The Hope Learning Center LLC —Mars, PA
- Full-time
- School experience
- CPR Certification
- Current TB test
- Paid holidays
- Health insurance
Quick Apply
11d
Procurement Operations Specialist
Grace Inspired Living —Telford, PA
- Full-time
- Hospitality
- Finance
- Analysis skills
- Health savings account
- Disability insurance
12d
Chief Innovation Officer (Legal)
Steptoe & Johnson PLLC —Pittsburgh, PA
- Extended hours
- Hybrid work
- Background check
- Bachelor's degree
- Travel
- Health savings account
- Health insurance
Quick Apply
Post Closer
HireQuest Inc. —Langhorne, PA
- $18 - $23 an hour
- Full-time
- Mid-level
- Office
- Windows
- Paid time off
- 401(k) matching
Quick Apply
6d

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RN, Regulatory Compliance Quality Specialist

Thomas Jefferson University and Hospitals -
Philadelphia, PA

Apply Now

Job Details

Full-time

Benefits

AD&D insurance
Disability insurance
Health insurance
Dental insurance
Flexible spending account
Tuition reimbursement
Vision insurance
Life insurance
Retirement plan
Prescription drug insurance

Qualifications

TJC
CMS
CMS regulatory compliance
Hospital accreditation
Bachelor's degree
Data interpretation
Cross-functional communication

Full Job Description

Job Details

The Quality Specialist ensures the accuracy and regulatory compliance of Jefferson Health's clinical quality data submitted to
CMS, The Joint Commission, and other agencies. This role oversees data abstraction, validation, and reporting across multiple
regulatory programs while managing key databases and vendor partners. The specialist provides actionable insights to
leadership, supports audit readiness, and helps drive systemwide quality improvement by maintaining reliable, transparent
performance data.

Job Description

Job Summary

Registered Nurse Preferred

The Quality Specialist ensures the accuracy and regulatory compliance of Jefferson Health's clinical quality data submitted to CMS, The Joint Commission, and other agencies. This role oversees data abstraction, validation, and reporting across multiple regulatory programs while managing key databases and vendor partners. The specialist provides actionable insights to leadership, supports audit readiness, and helps drive systemwide quality improvement by maintaining reliable, transparent performance data.

Essential Functions

Manage CMS regulatory programs (HIPQRP, HOPQRP, IPFQR, Star Rating).
Oversee data abstraction and ensure required sampling volumes are met (including GWTG).
Manage critical databases (GWTG, TJC-ORYX, eCQM, QNet, HQR, PEPPER portal).
Perform data validation and quality control (QC’d).
Generate and analyze reports using Medisolv and HQR.
Ensure timely and accurate regulatory submissions.
Support CMS validation (IP, OP & IPFQR) audits and prepare required documentation.
Manage abstraction vendors (HIA, Medisolv), review invoice for accuracy, and monitor performance.
Prepare executive summaries and communicate results to leadership.
Serve as subject matter expert (SME) on CMS and TJC requirements.
Upload data to regulatory agencies (TJC & CMS).
Participate in multidisciplinary committees and provide data insights.

Education - Required

Bachelor’s Degree Healthcare related field of study
Registered Nurse Preferred

Education - Preferred

Master’s Degree Healthcare related field

Experience - Required

5 years in healthcare quality or regulatory reporting

Knowledge, Skills and Abilities - Required

Knowledge of CMS and Joint Commission standards
Strong analytical and critical thinking skills
Attention to detail and accuracy
Effective communication and collaboration skills

Licenses and Certifications - Preferred

CPHQ - Certified Professional in Healthcare Quality - National Association for Healthcare Quality within 2 Years

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Albert Einstein Medical Center

Primary Location Address

5501 Old York Road, Philadelphia, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University , home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health , nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps ), have access to medical (including prescription) insurance.

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Refine Your Search

regulatory specialist jobs in pennsylvania

RN, Regulatory Compliance Quality Specialist

Benefits Verification Specialist

Senior Claim Benefit Specialist - Remote

Behavior Analyst

Chiropractor

Behavior Analyst - OPEN

Behavior Analyst - OPEN

Behavior Analyst - Open

Behavior Analyst

Pharmacy Quality Improvement Specialist | Onsite - Pittsburgh

Construction Safety Specialist

Direct Support Professional

Oral Surgeon

ACT Mental Health Therapist/Specialist - $7,000 Hiring Bonus

Workers' Compensation Nurse Case Manager - RNs ONLY

Commercial Loan Documentation Specialist

Special Education Director

Procurement Operations Specialist

Chief Innovation Officer (Legal)

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I want to receive the latest job alert for regulatory specialist in pennsylvania

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Job Summary

Essential Functions

Education - Required

Education - Preferred

Experience - Required

Knowledge, Skills and Abilities - Required

Licenses and Certifications - Preferred

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