Legislative Services Compliance Manager II

Exemption Status:United States of America (Exempt)

$102,260 - $140,608 - $178,955

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Monitors state and federal regulations, sub-regulatory guidance, and any other applicable communications distributed by regulatory bodies.

• Analyzes information for dissemination to appropriate internal operational areas and, where appropriate, prepares overviews and other documentation to serve as compliance guidance in relation to implementation of specified requirements. Interfaces with internal operational areas on compliance matters impacting MedImpact’s initiatives.

• Oversees internal implementation efforts relating to new legislation in concert with the Counsel, Legislative Services. Communicates to appropriate business units to ensure modifications are implemented as appropriate to ensure organization meets state and federal regulatory requirements

• Manages state regulatory reporting for initial and updated reporting and submission requirements. Works with internal subject matter experts, licensing, and outside counsel as appropriate.

• Develops and maintains state regulatory reporting repository (PBMSource) and C360 and serves as subject matter expert for applicability, scope, and reporting parameters according to state regulatory requirements.

• Interfaces with clients and legal counsel on matters relating to compliance with applicable laws or regulations.

• Assists with the development and review of organization’s policies and procedures in relation to state or federal regulations. Identifies needed policies and procedures in order to demonstrate compliance with applicable requirements and works with appropriate internal operational units to ensure creation and maintenance of needed documentation. Ensures policies and procedures are revised to address regulatory changes.

• Develops client communications relating to state and federal regulatory changes. Mentors and leads Regulatory Compliance, Government Programs and Services teams, and other functional teams, including facilitation of review meetings.

• Works directly with the Compliance Officer to support the Corporate Compliance Program in relation to new or amended requirements.

• Manages various organizational committees and/or work groups to disseminate federal and state compliance information. Maintains records, as appropriate, to memorialize decisions, direction, actions, and ensures information is retrievable.

• Communicates to appropriate business units to ensure modifications are implemented as appropriate to ensure organization meets state and federal regulatory requirements.

• Keeps up to date on the industry’s best practices and regulatory changes through PCMA and PBMSource.

• Leads and manages complex organizational corporate projects. (examples – NQTL, Website Accessibility, Consumer Protection Act)

• Develops and presents training to departments across the organization in relation to enacted state or federal laws that impact multiple lines of business and presents updates on initiatives to the Corporate Compliance Committee.

• Interfaces with Contracts Department to assist in the creation and modification of client contracts, pharmacy network contracts, vendor contracts, and regulatory addendums for state or federal regulations, as needed.

• Development and implementation of strategic initiatives relating to emerging state and federal regulations.

Supervisory Responsibilities        

No supervisory responsibilities.

Client Responsibilities

This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written).  One must be able to: Manage difficult or emotional situations; Respond promptly to compliance matters; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience  

Bachelor's degree (or equivalent combination of education and experience); minimum 7 years previous related experience; Prior experience working in regulatory compliance and ability to analyze legislation for applicability to the PBM business. required.

Computer Skills

Strong PC skills in Microsoft Office Suite, MS Outlook. Familiar with relational databases and industry specific software.

Certificates, Licenses, Registrations

None required

Other Skills and Abilities

• Solid working knowledge of current assigned state and federal regulatory requirements and related company training initiatives required
• Strong listening skills and ability to convey regulatory compliance information, verbally and in writing, in an easy to understand format to employees of organization

Language Skills                                           

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Mathematical Skills                                                 

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

Reasoning Ability                                                    

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Competencies                                              

To perform the job successfully, an individual should demonstrate the following competencies:

• Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.

• Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures.

• Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals.

• Planning/Organizing - Prioritizes and plans work activities; Uses time efficiently; Plans for additional resources; Sets goals and objectives; Organizes or schedules other people and their tasks; Develops realistic action plans.

• Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.

• Verbal Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.

• Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.

• Change Management - Develops workable implementation plans; Communicates changes effectively; Builds commitment and overcomes resistance; Prepares and supports those affected by change; Monitors transition and evaluates results.

• Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.

Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand and walk. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is occasionally exposed to risk of electrical shock. The noise level in the work environment is usually moderate.

Work Location

This position may work on-site at the San Diego Headquarters for purposes of providing adequate support to internal clients; being available for face-to-face interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as for facilitation of quick and effective decisions through collaboration with stakeholders.  Remote work is an option for these purposes.

Working Hours

This is an exempt level position requiring one to work the hours needed to get the job done.  Therefore one must have the flexibility to work beyond traditional hours and be able to work nights, weekends or on holidays as required.  This may be changed from time to time to meet the needs of the business.  Typical core business hours are Monday through Friday from 8:00am to 5:00pm.

Travel

This position requires no regular travel; however, attendance may be required at occasional conferences and meetings.

The Perks:

• Medical / Dental / Vision / Wellness Programs
• Paid Time Off / Company Paid Holidays
• Incentive Compensation
• 401K with Company match
• Life and Disability Insurance
• Tuition Reimbursement
• Employee Referral Bonus

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego,
California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/VeteransOSHA/ADA:

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above
statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.