Compliance Analyst (Regulatory Change Management) - Remote
At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.
The Compliance Analyst assists in the implementation of Prime's compliance programs within their designated areas and partners with key internal stakeholders to monitor aspects of compliance and validate policies, procedures, licensure, and program manuals are effectively followed and maintained.
Responsibilities :
- Executes compliance procedures and enforces policy governance across the organization to validate requirements are met and that business operations are aligned with expectations of applicable regulatory guidance
- Develop solutions to moderately complex compliance problems by referring to precedence, policies and standard operating procedures; escalate issues to Compliance leadership as appropriate
- Support and at times, lead the project management efforts of Compliance initiatives
- Represent the Compliance Department on projects of medium complexity, contracts or other cross-functional assignments
- May execute Prime's compliance programs by facilitating the development, maintenance and delivery of compliance training, administering the annual conflict of interest process, or completing regular review of standard operating procedures and policies; may develop annual revision and tracking process for policies and procedures and participate in department projects and improvement initiatives
- Research laws, industry guidance and regulatory issues that impact Prime's compliance programs or Board of Pharmacy and Department of Insurance filings; document requirements or disciplinary actions and escalate findings as appropriate
- If supporting licensing efforts, may manage regulatory submissions, filings, renewals, notifications, and periodic reports related to licensed functions (Pharmacy Benefit Management (PBM), Third Party Administrator, Utilization Review Organization, Business, State registrations etc.); compile required internal reports, perform research of licensing and reporting requirements, respond to requests for information and proposals, develop / revise / maintain departmental Standard Operating Procedures, Desk Top Procedures, and Licensing source documentation; May also manage the licensing IT application and conduct general maintenance of that tool
- Other duties as assigned
Minimum Qualifications :
Bachelor's degree in business, healthcare, or related area of study, or equivalent combination of education and / or relevant work experience; HS diploma or GED is required2 years of work experience in legal, compliance, or project / program coordination roles in healthcare, Pharmacy Benefit Management (PBM) or other highly regulated industryMust be eligible to work in the United States without the need for work visa or residency sponsorshipAdditional Qualifications :
Strong written and oral communication skillsDemonstrated ability to apply critical thinking skills and problem solve through complex situationsThorough understanding of effective compliance program principles, concepts, practices and standardsAbility to effectively present complex information to a wide variety of audiencesAbility to establish rapport and effectively influence at all levels within an organizationEnhanced organizational skills with the ability to effectively work on multiple projects simultaneouslyPreferred Qualifications :
Pharmacy Benefit Management / health care experienceMedicare Part D, Medicaid, and / or Affordable Care Act experienceCertified Compliance and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC)Certified Project Management Professional (PMP)If working within Licensing, experience maintaining, tracking, renewing and submitting applications for licensureEvery employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures. Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job. Potential pay for this position ranges from $59,000.00 - $94,000.00 based on experience and skills.
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer.