Compliance Principal - Remote

Posted Yesterday
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Home, KS
109K-174K Annually
Senior level
Insurance
The Role
The Compliance Principal ensures effective execution of the corporate compliance program, collaborating with various business areas and legal teams. Responsibilities include promoting compliance awareness, addressing compliance issues, leading compliance projects, monitoring regulatory changes, and representing the compliance program externally.
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 Principal - RemoteJob Description

The Compliance Principal is responsible for the successful execution of key components and elements of Prime’s corporate compliance program. This position works closely with designated business areas, legal, and other internal stakeholders on the development, implementation, and monitoring of compliance initiatives as well as identifying changing laws and regulations or client contractual compliance obligations, interpreting the impact and managing solutions for designated functions.  This role supports and partners directly with compliance department leadership and Prime’s Chief Compliance Officer.

Responsibilities

  • Promote awareness and engagement in organizational culture of compliance and ethics.
  • Serves as a compliance subject matter expert, providing strategic guidance and second line of defense oversight to improve organizational-wide processes and establish, measure, and improve compliance program practices.
  • Proactive identification and resolution of complex business and compliance issues, while aligning with organizational goals and minimizing friction and maximizing productivity and impact.
  • Serve as a trusted partner working cross functionally with operational business teams building a deep understanding of how their teams work, their needs and how compliance requirements can be operationalized in their teams and work.
  • Leads compliance program process execution in assigned function to ensure organizational obligations are met and business operations are aligned with applicable laws and regulatory guidance.
  • Provide consultative leadership and direct efforts to communicate compliance program components, including training and education materials designed to promote understanding of compliance elements, regulations and laws, and consequences of non-compliance.
  • Lead successful implementation of projects and initiatives, including developing, leading and/or oversight of large, complex initiatives that may be function-specific and/or involve multiple business areas and partners.
  • Monitor changes to laws, regulatory enforcement trends and industry landscape to stay ahead of evolutions, trends and best practices to inform business strategy and compliance program strategic plan.
  • Develop, track, and produce data metric reports demonstrating compliance program effectiveness.
  • Represent Prime, the Compliance program and its interests in external interactions with trade associations, State and Federal regulators, consulting agencies and accrediting bodies.
  • 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 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

Additional Qualifications

  • Strong interpersonal communication skills, including team leadership, conflict resolution, listening, establishing rapport and effectively influence at all levels within an organization, and leading meetings with various leaders in an organization.
  • Well-developed organization, analytical, interpretative and time management skills with the ability to effectively work on multiple projects simultaneously.
  • Expert level understanding of effective compliance 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 priorities.
  • Demonstrated ability to apply critical thinking skills to proactively identify issues and problem solve through the most complex compliance situations.
  • Demonstrated oral and written communication skills, including ability to effectively interpret and present complex information to a wide variety of audiences.
  • Ability to simultaneously manage multiple projects within strict timelines, under pressure.
  • Working knowledge of Medicare Part D, Medicaid, state healthcare product or program related regulations and/or Health Insurance Marketplace guidance
  • Experience identifying opportunities for improvement and leading the implementation of process changes.
  • Strong problem solving and decision-making skills.
  • Effective use of interpersonal skills including the ability to handle conflict, promote teamwork, display empathy, and maintain a positive attitude.
  • Proficiency using MS Office

Preferred Qualifications

  • Certified Compliance and Ethics Professional (CCEP) or Certified in Healthcare Compliance (CHC)
  • Advanced degree in relevant discipline (JD, MBA, MHA, MPA, etc.)
  • Pharmacy Benefit Manager or health care insurance regulatory affairs/compliance experience preferred with a strong understanding of issues surrounding this industry

Minimum Physical Job Requirements

  • 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

Reporting Structure

  • Reports to AVP or CCO in the Compliance department

Potential pay for this position ranges from $109,000.00 - $174,000.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.

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, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by 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.

The Company
HQ: Eagan, MN
3,577 Employees
On-site Workplace
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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