Job Description
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Role Description
- We are looking for a Compliance Analyst to assist in all operational aspects of implementing a highly-effective compliance program in a dynamic PBM regulatory landscape. This position will focus on risk detection, auditing, monitoring, and development of these elements.
- Assist, build, and lead initiatives which detect and mitigate organization risks using the key seven elements of a compliance program
- Work closely with the Corporate Compliance department and business areas across the organization to support our mission
- Qualifications
- Bachelor’s degree or higher education in healthcare, compliance, or a related field, or equivalent years of relevant work experience is required
- Minimum of four (4) years of compliance experience at a PBM or health plan, and pharmacy operations oversight or similar experience would be considered
- Direct experience with pharmacy benefits, network, and claims is a bonus
- Requirements
- Certified in Healthcare Compliance (CHC), Certification in Healthcare Privacy Compliance (CHPC), or Certified Compliance and Ethics Professional (CCEP) preferred
- Current, unrestricted clinical or functional business licensure is a bonus (examples: certified pharmacy technician)
- Strong understanding with the seven elements of a highly effective compliance program
- Strong familiarity with PBM-related healthcare operations and/or clinical concepts, practices and procedures is preferred, or similar health plan knowledge will be considered
- Strong working knowledge of healthcare compliance audit and monitoring activities, compliance risk assessments
- Working knowledge of external audit functions and procedures
- Strong familiarity with ERISA, Healthcare Exchange Marketplace (Affordable Care Act), Worker’s Compensation, and Medicare preferred
- Familiarity with pharmacy operations and healthcare benefits
- Data-driven, big-picture thinker, and solutions-oriented
- Professional verbal and written communication skills including proper grammar, construct, and appropriate to the audience
- Advanced organizational, project, and time management skills to prioritize, prepare, and leverage resources and stay on focus
- Ability to work independently and within a team environment
- Ability to establish effective collaborative techniques, such as conflict resolution
- Benefits
- Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance and AD&D Insurance
- Flexible Spending Benefits
- 401(k) Retirement Savings Program
- Short-term and long-term disability
- Discretionary Paid Time Off
- Paid Company Holidays
- Wellness Benefits
- Commuter Benefits
- Paid Parental Leave benefits
- Employee Assistance Program (EAP)
- Well-stocked kitchen in office locations
- Professional development and training opportunities
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