Compliance Analyst Principal (Performance and Oversight) - Remote

Reposted 2 Days Ago
Hiring Remotely in Home, PA
In-Office or Remote
94K-160K Annually
Senior level
Insurance
The Role
The Compliance Analyst Principal supports compliance programs, manages the Riskonnect Compliance module, conducts analysis, and oversees compliance initiatives while providing guidance to teams.
Summary Generated by Built In

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 Principal (Performance and Oversight) - RemoteJob Description

The Compliance Principal is responsible for supporting Oversight and Monitoring of Compliance Programs by directing and assisting leaders in the implementation, monitoring, and maintenance of regulatory requirements throughout the enterprise. This position acts as the subject matter expert on applicable regulations, training, and awareness programs, and for responding to compliance-related inquiries.

Responsibilities

  • Successfully manage Riskonnect Compliance module. As a technical SME for the Riskonnect Compliance module, provide expert guidance on compliance-related matters within the platform.
  • Guiding a product from ideation to launch and beyond, focusing on balancing customer needs with business goals. 
  • Consults with business areas and other subject matter experts to identify compliance requirements, assess risks, and recommend compliant solutions that support enterprise goals
  • Conducts analysis to create written reports, process flows, and other documentation. Represent AVP of compliance and managers in work groups, committees, and special meetings when needed
  • Leads and supervise employees on assigned tasks, project risk assessments and manage relationships to help ensure efficient and effective solutions are implemented
  • Perform and review detail plans to address complex compliance issues by identifying goals, objectives, and risks to achieving compliance outcomes. Coordinate with business owners to implement corrective action plans
  • Develops compliance communication for risk assessment and corrective action plans for the Chief Compliance Officer’s reporting to the Corporate Compliance Committee (CCC) and Finance, Compliance & Audit Committee (FCA) meeting materials.
  • Act as a liaison between technical and non-technical staff, communicating business requirements in a clear and understandable way.
  • Collaborate with internal and external vendor IT teams to ensure systems are configured and maintained properly.
  • Oversee the implementation and maintenance of Compliance system modules
  • Monitor system performance and make recommendations for improvements.
  • 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
  • 8 years of progressive work experience in legal or compliance related roles for a healthcare or Pharmacy Benefit Management organization, or within a 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

  • Exceptional written and oral communication skills
  • Demonstrated ability to apply critical thinking skills to proactively identify issues and problem solve through the most complex compliance and ethics situations
  • Extensive experience assessing training requirements and developing, delivering and assessing effective enterprise compliance and ethics training programs through a variety of channels
  • Expert level understanding of effective compliance and ethics program principles, concepts, practices and standards; full breadth of knowledge around industry best practices and challenges and experience developing new concepts, techniques, standards and programs to support an organization’s compliance and ethics priorities
  • Extensive experience establishing rapport and effectively influencing all levels within an organization
  • Advanced organizational skills with the ability to effectively work on multiple projects simultaneously

Preferred Qualifications

  • Previous leadership/people management experience
  • PBM/health care experience
  • Certified Compliance and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC)
  • Advanced degree in related area of study, such as Juris Doctor
  • Medicare Part D, Medicaid, and/or Affordable Care Act knowledge and experience

Physical Demands

  • Ability to travel up to 20% 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 $94,000.00 - $160,000.00 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.

Top Skills

Compliance Software
Riskonnect Compliance Module
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The Company
HQ: Eagan, MN
3,577 Employees
Year Founded: 1987

What We Do

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 20 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.

Follow Prime on LinkedIn to learn more.

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