PBM Licensing & Compliance Manager

Overview:

The PBM Licensing & Compliance Manager leads Licensing Associates & Specialists, performing a wide variety of specialized operational functions for the Legal and Compliance department including pharmacy benefit management licensure, reporting, Medicaid provider enrollment, business registration, research, regulatory support, administrative support, and projects as assigned.

Position Location:

This is a remote-based position within the Continental US.

Ideal Experience Profile

*  4+ years of pharmacy benefit management (PBM) licensing or equivalent experience

*  2+ years of experience in handling provider applications for enrollment in Medicaid or Medicare

*  1+ year of experience in completing and maintaining business registrations

*  Intermediate knowledge of Microsoft Office and Adobe products

*  Roles within legal (paralegal), regulatory, audit, and/or compliance departments

*  Advanced technical level skillset with Microsoft Office and Adobe Acrobat products

*  Possess a strong attention to detail and consistently adhere to administrative procedures and regulatory timelines

*  Able to review and research state and federal regulations and determine how regulations apply from licensing and reporting perspective

*  Must have strong written and verbal communication skills

*  Effectively develop meaningful relationships with a wide range of individuals at all levels of an organization, both internal and external

*  Thoughtfully addresses requests for information and raise items to management as warranted

*  Must have a strong working knowledge of Microsoft Office (specifically, Word, Outlook, and Excel) and Adobe Acrobat

Our Company

Founded in 1926, Maxor is a leading, independent pharmacy solutions platform that improves prescription drug affordability and outcomes. Over time, Maxor has built a unique and complementary suite of services and technology offerings that deliver clinical, financial and strategic value to patients, payors and providers across the pharmacy supply chain. Maxor has a proud heritage of growth and innovation earned over the decades. Amarillo, Texas is the legacy headquarters for Maxor, but our talent base is national. We operate pharmacies and other business operation sites across the United States with more than 1200 employees working from 42 states.

Why Maxor?

Pharmacies are essential to healthcare, with nearly 90% of the US population living within 5 miles of one and seeing their pharmacist an average of 12 times a year. Providing a positive patient experience is crucial to ensuring patients adhere to their therapies.  

At Maxor, we recognize that our employees are our most valuable assets and we actively seek and retain talented professionals who are mission-driven to improve healthcare outcomes for patients. Our employees are also essential to their own well-being, finding fulfillment in meaningful work, competitive compensation, diverse and inclusive teams, and limitless career possibilities.  With a almost a century of pharmacy experience, we offer the stability of a Fortune 500 company and the energy and innovation of a startup. Our expertise and technology support the entire pharmacy ecosystem, but our impact goes beyond pharmacy services. We enable pharmacy care. 

LICENSING:

• Supervises and trains Licensing Associates and Licensing Specialists
• Actively participates in cross-functional planning meetings
• Creates and implements the plan for licensing projects
• Serves as primary support and subject matter expert for all licensure functions and processes
• Develops and maintains meaningful relationships with internal stakeholders, state, and federal regulators
• Meets all licensure and reporting deadlines
• Leads PBM reporting to regulatory agencies

MEDICAID AND MEDICARE ENROLLMENT:

• Serves as primary support and subject matter expert for provider enrollment applications in Medicaid and Medicare
• Actively participates in cross-functional pharmacy implementation meetings

BUSINESS REGISTRATION:

• Serves as primary support for all business registration processes
• Provides assistance to primary support in order to meet business registration deadlines

RESEARCH:

• Serves as primary support for licensing-related research requests
• Serves as secondary support for research on new laws and regulations impacting the PBM

PROJECTS & ADMINISTRATION:

• Executes or provides assistance with projects as assigned
• Maintain and update databases and tracking systems
• Create and design general correspondences, memos, business information etc. Proofread copy for spelling, grammar, and layout, making appropriate changes.  Responsible for accuracy and clarity of final copy.
• Create, compose, and edit technical and/or administrative correspondence and documentation; screen and evaluate incoming and outgoing correspondence and prepare responses as appropriate
• Prepare internal reports such as check requests, expense reports, IT requests, etc.
• Enhance professional growth and development through participation in educational programs, current literature, in-service meetings, and workshops.
• Maintain good inter/intra departmental relationships. Work to create an amiable atmosphere within the department and company.
• Respond to change, performance improvement support, professional growth opportunities, and meet development goals.
• Maintain regular attendance in accordance with established policies.
• Perform other job-related duties as assigned.
• Travel up to 10% of time

Education: 

• High school diploma or equivalent. College degree preferred.

Experience:   

    Required:

• 4+ years of pharmacy benefit management (PBM) licensing or equivalent experience
• 2+ years of experience in handling provider applications for enrollment in Medicaid or Medicare
• 1+ year of experience in completing and maintaining business registrations
• Intermediate knowledge of Microsoft Office and Adobe products

     Preferred:

• Roles within legal (paralegal), regulatory, audit, and/or compliance departments
• Advanced technical level skillset with Microsoft Office and Adobe Acrobat products

Knowledge, Skills, and Abilities:

• Possess a strong attention to detail and consistently adhere to administrative procedures and regulatory timelines
• Able to review and research state and federal regulations and determine how regulations apply from licensing and reporting perspective
• Must have strong written and verbal communication skills
• Effectively develop meaningful relationships with a wide range of individuals at all levels of an organization, both internal and external
• Thoughtfully addresses requests for information and raise items to management as warranted
• Must have a strong working knowledge of Microsoft Office (specifically, Word, Outlook, and Excel) and Adobe Acrobat
• Continually seek ways to improve processes and propose changes effectively
• Create, compose, and edit written materials, effectively execute tasks, and organize efficiently
• Document matters as warranted and communicate and/or store information as needed
• Possess knowledge and experience to make administrative and minor procedural decisions and judgments on sensitive, confidential issues with little to no direction
• Gather data from internal sources, compile information, and prepare reports
• Prioritize, organize and coordinate daily work timely; effectively work under pressure, and manage to competing deadlines with some direction
• Develop and maintain record keeping systems and procedures
• Maintain the highest level of confidentiality of company, personal, and sensitive information

WE OFFER

At Maxor, we foster a diverse and progressive culture that promotes a work-from-home model and a "dress-for-your-day" approach to work attire. Our team-oriented environment encourages collaboration and innovation. We offer highly competitive compensation and comprehensive health benefits including:

• Comprehensive mental health and wellbeing resources
• Nationwide Blue Cross Blue Shield PPO with employee-friendly plan design, including a $850 individual annual medical deductible and $25 office visit copays, with low biweekly premiums
• Company-paid basic life/AD&D, short-term and long-term disability insurance
• Rx, dental, vision, other voluntary benefits, and FSA
• Employer-matched 401k Plan
• Industry-leading PTO plan
• And more!

Apply today at: https://www.maxor.com/careers/     

Maxor is an EOE, including disability/vets