Sr. Compliance Analyst - Remote

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

Sr. Compliance Analyst - Remote

Job Description

The Regulatory Intelligence 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, support and review of member/provider communications, manuals and materials. This role supports the Regulatory Intelligence Team.

Responsibilities

• Supports the Regulatory Intelligence team and client interface and communication principal, manages Departmental mailboxes and triages inquiries, requests and escalations to appropriate staff or management 
• Develop solutions to moderately complex compliance problems by referring to precedence, policies and standard operating procedures; escalate issues to Compliance leadership as appropriate 
• Maintains tracking logs and ensures thorough records are developed and maintained, with emphasis on accuracy, relevance, and timeliness; prepare necessary documentation for client interface activities including deliverables, reports, findings and recommendations; provide clear and concise response communications to internal and external stakeholders. 
• 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 
• Research laws, industry guidance and regulatory issues that impact Prime’s compliance programs; document requirements and escalate findings as appropriate  
• 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  
• 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, an