Job Description
Note:
The job is a remote job and is open to candidates in USA. Prime Therapeutics is a purpose-driven PBM focused on connecting care for those they serve. The Compliance Analyst will assist in implementing compliance programs, monitor compliance aspects, and validate policies and procedures within the organization. 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 Skills • 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 required • 2 years of work experience in legal, compliance, or project/program coordination roles in healthcare, Pharmacy Benefit Management (PBM) or other highly regulated industry • Must be eligible to work in the United States without the need for work visa or residency sponsorship • Strong written and oral communication skills • Demonstrated ability to apply critical thinking skills and problem solve through complex situations • Thorough understanding of effective compliance program principles, concepts, practices and standards • Ability to effectively present complex information to a wide variety of audiences • Ability to establish rapport and effectively influence at all levels within an organization • Enhanced organizational skills with the ability to effectively work on multiple projects simultaneously • Pharmacy Benefit Management/health care experience • Medicare Part D, Medicaid, and/or Affordable Care Act experience • Certified 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 licensure Company Overview • Prime Therapeutics is a trusted pharmacy solutions partner delivering savings, simplicity & support to our customers and members It was founded in 1990, and is headquartered in Eagan, Minnesota, USA, with a workforce of 5001-10000 employees.
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