Senior Compliance Analyst; Regulatory Change Management – Remote

Position: Senior 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. Senior Compliance Analyst (Regulatory Change Management) – Remote

Job Description

The Senior Compliance Analyst assists in the implementation of Prime’s compliance programs and leads initiatives within their designated areas. This role 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 regulatory reporting requirements are met and that business operations are aligned with expectations of applicable regulatory guidance
• Lead project management efforts for highly sensitive Compliance initiatives
• Represents the Compliance Department on complex contracts or cross-functional projects; identifies key stakeholders from across the enterprise and establishes effective collaboration techniques to maintain ongoing partnership between functions
• May collect, prepare and maintain records and related documentation for reporting to the Chief Compliance Officer, Prime’s senior leadership team, executives, Corporate Compliance Committee members and the Board of Directors; collaborates across the compliance organization to collect and organize information into clear, accurate and effective executive reports
• Serves as subject matter expert within Compliance and develops solutions to highly complex compliance problems by referring to precedence, policies and standard operating procedures; escalse issues to Compliance leadership as appropriate and enhance or develop new supporting documentation as necessary
• May execute and enhance Prime’s compliance programs by developing, maintaining and delivering compliance documentation and training, administering the annual conflict of interest or other cyclical compliance processes, or implementing a regular review cadence for standard operating procedures (SOP) and policies
• Research and interpret 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 escalse 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 SOPs, Desk Top Procedures, and Licensing source documentation; manage the licensing IT application and conduct general maintenance of the licensing tools
• 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
• 5 years of progressive work experience in legal or compliance related roles for a healthcare or PBM organization, or other highly regulated industry, including experience with Medicare, Medicaid, and the Affordable Care Act (ACA)

Must be eligible to work in the United States without the need for work visa or residency sponsorship Additional Qualifications

• Exceptional written and oral communication skills
• Demonstrated ability to apply critical thinking skills and problem solve through highly complex situations
• Complete understanding of effective compliance program principles, concepts, practices and standards; full breadth of knowledge around industry best practices and challenges; experience developing new concepts, techniques, standards and programs to support an organization’s compliance priorities
• Ability to effectively present complex information to a wide variety of audiences
• Ability…

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