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Compliance Analyst - Corrections

3 hours, 24 minutes ago
United States
Full-time
Mid Level
Compliance Manager
Operations
Apply Now
SmithRx

SmithRx

SmithRx revolutionizes pharmacy benefits with transparent technology, connecting stakeholders for efficient drug delivery and cost savings.

Pharmaceuticals
1K-5K
Founded 2016
$38M raised
View All Jobs 27

Description

  • Design and enhance the corrective action process.
  • Assess and prioritize corrective action referrals.
  • Initiate corrective actions such as corrective action plans and warning letters.
  • Collaborate with business stakeholders to perform root cause analysis and identify prevention, detection, and correction opportunities.
  • Ensure business partners complete corrective actions in a timely and effective manner.
  • Identify and help mitigate organizational compliance risks.
  • Develop job aids, playbooks, and other program documentation.
  • Build and maintain positive relationships with internal and external stakeholders.
  • Support a compliant and ethical culture across the organization.
  • Assist with oversight materials, reporting metrics, compliance training, and education needs.
  • Investigate potential or reported non-compliance issues.
  • Collaborate with Legal and other stakeholders to interpret regulations.

Requirements

  • Bachelor’s degree or higher in healthcare, compliance, or a related field, or equivalent relevant work experience.
  • Minimum of 4 years of compliance experience at a PBM or health plan, or similar pharmacy operations oversight experience.
  • Direct experience with pharmacy benefits, network, and claims is a bonus.
  • CHC, CHPC, or CCEP certification preferred.
  • Current, unrestricted clinical or functional business licensure is a bonus, such as certified pharmacy technician.
  • Strong understanding of the seven elements of an effective compliance program.
  • Strong familiarity with PBM-related healthcare operations and/or clinical concepts is preferred, or similar health plan knowledge.
  • Working knowledge of healthcare compliance program corrective actions and external audit functions/procedures.
  • Strong familiarity with ERISA, ACA Marketplace, Workers’ Compensation, and Medicare is preferred.
  • Professional verbal and written communication skills, advanced organizational skills, and the ability to work independently and in a team environment.

Benefits

  • Competitive base salary of $89,300-$126,000 depending on location and experience.
  • Potential eligibility for bonuses, commissions, or equity.
  • Medical, pharmacy, dental, vision, life, and AD&D insurance.
  • Flexible spending benefits and commuter benefits.
  • 401(k) retirement savings program.
  • Short-term and long-term disability coverage.
  • Discretionary paid time off plus 12 paid holidays.
  • Paid parental leave, employee assistance program, wellness benefits, and mental health support.
  • Professional development and training opportunities.

Interested in this position?

Apply directly on the company website

Apply Now

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