Demo

Compliance Analyst Sr Medical Pharmacy Specialty- REMOTE

Prime Therapeutics
Albuquerque, NM Remote Full Time
POSTED ON 3/4/2025
AVAILABLE BEFORE 6/4/2025

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

Compliance Analyst SrMedical Pharmacy Specialty- 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 monitor aspects of compliance and validate policies, procedures, licensure, and program manuals are effectively followed and maintained.

Responsibilities

  • Executes compliance procedures and enforces policy governance across the organization to validate regulatory reporting 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
  • May execute and enhance Prime's compliance programs by developing, maintaining and delivering compliance documentation and training, administering the annual conflict of interest or other cyclical compliance processes, or implementing a regular review cadence for standard operating procedures (SOP) and policies
  • 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
  • If supporting licensing efforts, may manage regulatory submissions, filings, renewals, notifications, and periodic reports related to licensed functions (Pharmacy Benefit Management (PBM), Third Party Administrator, Utilization Review Organization, Business, State registrations, etc); compile required internal reports, perform research of licensing and reporting requirements, respond to requests for information and proposals, develop / revise / maintain departmental SOPs, Desk Top Procedures, and Licensing source documentation; manage the licensing IT application and conduct general maintenance of the licensing tools
  • 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 Advantage and Medicare Part B
  • 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

  • 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

  • Medical Pharmacy / Specialty drug exp
  • Health plan 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
  • Implementation / Project management experience
  • Medicare Advantage / Medicare Part B
  • 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 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.

    Salary : $74,000 - $118,000

    If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution. Compensation Planning
    Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right. Surveys & Data Sets

    What is the career path for a Compliance Analyst Sr Medical Pharmacy Specialty- REMOTE?

    Sign up to receive alerts about other jobs on the Compliance Analyst Sr Medical Pharmacy Specialty- REMOTE career path by checking the boxes next to the positions that interest you.
    Income Estimation: 
    $91,142 - $116,690
    Income Estimation: 
    $116,347 - $154,557
    Income Estimation: 
    $150,417 - $183,047
    Income Estimation: 
    $60,507 - $76,515
    Income Estimation: 
    $73,707 - $95,263
    Income Estimation: 
    $80,876 - $132,043
    Income Estimation: 
    $77,899 - $100,402
    Income Estimation: 
    $123,739 - $165,355
    Income Estimation: 
    $163,270 - $214,905
    Income Estimation: 
    $150,417 - $183,047
    Income Estimation: 
    $73,707 - $95,263
    Income Estimation: 
    $91,142 - $116,690
    Income Estimation: 
    $80,876 - $132,043
    Income Estimation: 
    $91,142 - $116,690
    Income Estimation: 
    $116,347 - $154,557
    Income Estimation: 
    $150,417 - $183,047
    View Core, Job Family, and Industry Job Skills and Competency Data for more than 15,000 Job Titles Skills Library

    Job openings at Prime Therapeutics

    Prime Therapeutics
    Hired Organization Address Bismarck, ND Full Time
    Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. ...
    Prime Therapeutics
    Hired Organization Address Providence, RI Full Time
    Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. ...
    Prime Therapeutics
    Hired Organization Address Providence, RI Full Time
    Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. ...
    Prime Therapeutics
    Hired Organization Address Hartford, CT Full Time
    Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. ...

    Not the job you're looking for? Here are some other Compliance Analyst Sr Medical Pharmacy Specialty- REMOTE jobs in the Albuquerque, NM area that may be a better fit.

    Compliance Analyst Sr--Medical Pharmacy Specialty- REMOTE

    Prime Therapeutics LLC, Albuquerque, NM

    Sr Analyst, Medical Economics (NY Medicaid Market) - REMOTE

    Molina Healthcare Group, Albuquerque, NM

    AI Assistant is available now!

    Feel free to start your new journey!