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Senior Compliance Analyst (Compliance Oversight Activities) - Remote

Role overview

Qualifications

  • Bachelor’s degree in business, healthcare, or related area of study
  • 5 years of progressive work experience in legal or compliance related roles for a healthcare or PBM organization
  • Exceptional written and verbal communication skills
  • Ability to present complex information and influence stakeholders at all organizational levels

Responsibilities

  • Lead compliance oversight activities including monitoring, reviews, issue management, and corrective action plan governance.
  • Execute compliance procedures and enforce policy governance to validate regulatory reporting and operational requirements are met.
  • Serve as a compliance subject matter expert and develop solutions to highly complex issues.
  • Prepare clear and accurate compliance records, reporting and materials for senior leadership and governance committees.

Key facts

  • Remote from: United States
  • Full time
  • Senior (5-10 years)
  • Compliance Analyst
  • 74 - 118K yearly
  • English

Hard skills

Other skills

  • Critical Thinking
  • Problem Solving
  • Non-Verbal Communication
  • Analytical Skills
  • Organizational Skills

About the company

Prime Therapeutics logo

Prime Therapeutics

Pharmacy Benefit Management (PBM)

Everything we do is connected to helping people get the medicine they need to feel better and live well. It’s meaningful work and we’ve been doing it for over 24 years. In the pharmacy benefit management (PBM)industry, we’re different. We’re owned by 18 not-for-profit Blue Cross and Blue Shield health plans. This allows us to control costs and empower our employees to put members first. It’s a successful combination. We have the lowest pharmacy trend in the industry and serve 28+ million members throughout the US. In addition to core PBM services, we work closely with our clients to implement the right benefit design, clinical and specialty programs, formulary and networks. A few key products: • NetResults™ • Specialty Drug Management • Best in Care™ • GuidedHealth® • Advanced Fraud, Waste and Abuse: Member and Prescriber Investigations • Prime Analytics™ • CareCentered Contracting™Controlled Substance Management Program Join us! Prime is always looking for smart, purposeful people to join our team. We’re growing fast which means there are plenty of opportunities to advance and grow in your career. At the same time, Prime supports flexibility and offers generous PTO so you can enjoy an enviable work/life balance. We’re a privately held company -big enough to make a difference and small enough for you to have an impact. Prime’s recruiting team will only contact you via phone call or through a corporate email address. Do not respond to suspicious emails or social media messages. If you have questions or are skeptical about any follow-up communications, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.

Company details

Company typeLarge
IndustryPharmacy Benefit Management (PBM)
Company size1001 - 5000

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Job description

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 (Compliance Oversight Activities) - Remote

Job Description

The Senior Compliance Analyst leads compliance initiatives within assigned areas and supports implementation of enterprise compliance programs. This role manages sensitive projects, serves as a subject matter expert, interprets complex requirements, develops executive reporting, and partners across the organization to support compliance oversight, including monitoring, issue management, corrective action governance, and regulatory compliance activities.


Responsibilities

  • Lead compliance oversight activities including monitoring, reviews, issue management, and corrective action plan governance.
  • Execute compliance procedures and enforce policy governance to validate regulatory reporting and operational requirements are met
  • Serve as a compliance subject matter expert and develop solutions to highly complex issues and escalate findings as appropriate; enhance supporting documentation
  • Represent Compliance on complex contracts and cross-functional projects and establish effective stakeholder partnerships
  • Lead project management for highly sensitive or complex compliance initiatives and represent Compliance on cross-functional projects and contracts.
  • Prepare clear and accurate compliance records, reporting and materials for senior leadership and governance committees
  • Build effective relationships and influence stakeholders across organizational levels.
  • Other duties as assigned

Minimum Qualifications

  • Bachelor’s degree in business, healthcare, or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma from an accredited school or equivalent GED 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 the need for work visa or residency sponsorship


Additional Qualifications

  • Exceptional written and verbal communication skills
  • Critical thinking and problem-solving skills for highly complex situations
  • Comprehensive understanding of effective compliance program principles, practices, standards, industry challenges, and emerging approaches
  • Ability to present complex information and influence stakeholders at all organizational levels
  • Advanced organization and analytical skills with ability to manage multiple projects simultaneously

Preferred Qualifications

  • PBM or healthcare experience
  • Certified Compliance and Ethics Professional (CCEP) or Certified in Healthcare Compliance (CHC)
  • Project Management Professional (PMP)
  • Medicare Part B Drug & Part D, Medicaid, and/or Affordable Care Act experience

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


Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job

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 (https://www.primetherapeutics.com/benefits).

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 (including pregnancy), 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.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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