Senior Compliance Analyst (Hotline and Incident Management) - Remote

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.

Job Posting Title

Senior Compliance Analyst (Hotline and Incident Management) - Remote

Job 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 hotline inquiry and incident management and investigations, conflict of interest management, governance reporting, as well as executing program effectiveness data-driven reporting or dashboards.

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; 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.
• Must be eligible to work in the United States without the need for work visa or residency sponsorship.

Additional Qualifications

• Experience with managing compliance investigations or incident response, conflict of interest disclosures, and compliance data analysis and reporting, including experience with Microsoft SharePoint and 365 apps (i.e., Teams, Forms, Lists, Power BI). 
• 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

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

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 requir