Senior Compliance Analyst - Remote

Posted 2 Days Ago
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Hiring Remotely in Home, PA
Remote
74K-118K Annually
Senior level
Insurance
The Role
The Senior Compliance Analyst leads compliance program initiatives, collaborates with stakeholders, manages projects, and ensures adherence to regulatory requirements in the healthcare industry.
Summary Generated by Built In

Our work matters. We help people get the medicine they need to feel better and live well.  We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Posting Title

Senior Compliance Analyst - RemoteJob 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 execute compliance program and compliance department activities related to demonstrating compliance program effectiveness through compliance attestations, external audit or client oversight activities, and RFP responses as well as executing review and validation of compliance related contract provisions.

Responsibilities

  • Executes compliance procedures and enforces policy governance across the organization to validate regulatory 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; escalate issues to Compliance leadership as appropriate and enhance or develop new supporting documentation as necessary.
  • 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 escalate findings as appropriate.
  • 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
  • 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 need for work visa or residency sponsorship

Additional Qualifications

  • Experience with RFP response management, review and assessment of contract requirements, and/or development of audit response strategies to demonstrate compliance program effectiveness.
  • 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 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.
  • Strong analytical skills

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.

Preferred Qualifications

Pharmacy services, PBM, managed care or health care industry experience Certified Compliance and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC) Certified Project Management Professional (PMP) Advanced degree in related area of study, such as Juris Doctor

Potential pay for this position ranges from $74,000.00 - $118,000.00 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page 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.

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The Company
HQ: Eagan, MN
3,577 Employees
On-site Workplace
Year Founded: 1987

What We Do

Everything we do is connected to helping people get the medicine they need to feel better and live well. It’s meaningful work and we’ve been doing it for over 20 years.

In the pharmacy benefit management (PBM)industry, we’re different. We’re owned by 18 not-for-profit Blue Cross and Blue Shield health plans. This allows us to control costs and empower our employees to put members first. It’s a successful combination. We have the lowest pharmacy trend in the industry and serve 28+ million members throughout the US.

In addition to core PBM services, we work closely with our clients to implement the right benefit design, clinical and specialty programs, formulary and networks. A few key products:
• NetResults™
• Specialty Drug Management
• Best in Care™
• GuidedHealth®
• Advanced Fraud, Waste and Abuse: Member and Prescriber Investigations
• Prime Analytics™
• CareCentered Contracting™Controlled Substance Management Program

Join us!
Prime is always looking for smart, purposeful people to join our team. We’re growing fast which means there are plenty of opportunities to advance and grow in your career.

At the same time, Prime supports flexibility and offers generous PTO so you can enjoy an enviable work/life balance. We’re a privately held company -big enough to make a difference and small enough for you to have an impact.

Follow Prime on LinkedIn to learn more.

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