Job Description
Position: 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. Compliance Analyst (Regulatory Change Management) –
Remote Job Description
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. • Develops solutions to moderately complex compliance problems by referring to precedence, policies and standard operating procedures; escalates issues to Compliance leadership as appropriate. • Supports and at times leads the project management efforts of Compliance initiatives.
• Represents 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.
• Researches laws, industry guidance and regulatory issues that impact Prime’s compliance programs or Board of Pharmacy and Department of Insurance filings; documents requirements or disciplinary actions and escalates 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.); compiles required internal reports, performs research of licensing and reporting requirements, responds to requests for information and proposals, develops/revises/maintains 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 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. Additional Qualifications • 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. Preferred Qualifications • 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. Every 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… Apply tot his job