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Job Posting Title

Sr. Compliance Analyst - Remote

Job Description

The Regulatory Inquiry & Complaints Senior Compliance Analyst assists in the implementation of Prime’s compliance programs, may lead some initiatives within their designated areas, and partners with key internal stakeholders to research and resolve regulatory inquiries/complaints related to claims, contracting and pharmacy reimbursement.  Works directly with business partners across the enterprise.

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

+ Develop solutions to compliance problems by referring to precedence, policies and standard operating procedures; escalate issues to Compliance leadership as appropriate

+ 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

+ 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 business operations; 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

+ 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

+ If working within Licensing, experience maintaining, tracking, renewing and submitting applications for licensure

Preferred Qualifications

+ PBM/health care 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

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 $74,000.00 - $118,000.00 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 (including pregnancy), 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].