Compliance Analyst -Medicare Part B- REMOTE - #250502

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Job Posting Title

Compliance Analyst -Medicare Part B- REMOTE

Job Description

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
• 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
  
  

Education & Experience

• 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 need for work visa or residency sponsorship
  
  

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
  
  

Physical Demands

• Ability to travel up to 10% of the time
• Constantly required to sit, use hands to handle or feel, talk and hear
• Frequently required to reach with hands and arms
• Occasionally required to stand, walk and stoop, kneel, and crouch
• Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus
  
  

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 requirements and internal policies and procedures.

Potential pay for this position ranges from $59,000.00 - $94,000.00 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https://www.primetherapeutics.com/benefits) and click on the "Benefits at a glance" button for more detail.

_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 (pregnancy, sexual orientation, and gender identity), 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.

Positions will be posted for a minimum of five consecutive workdays.

Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.

If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.

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 (pregnancy, sexual orientation, and gender identity), 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.

If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email [email protected].