Compliance Analyst -Medicare Part B- REMOTE

Lensa; Des Moines (IA); Remote; USD 59,000 - 94,000; Full time

Job summary

A leading healthcare organization is seeking a Compliance Analyst for Medicare Part B. This remote role involves implementing compliance programs, executing procedures, and managing projects to ensure adherence to regulatory standards. Ideal candidates will have a bachelor's degree and at least two years of relevant experience in a regulated industry.

Qualifications

• Bachelor’s degree or equivalent experience required.
• At least 2 years of experience in compliance or project coordination roles.

Responsibilities

• Executes compliance procedures and enforces policy governance.
• Develops solutions to compliance problems and supports project management.
• Researches regulatory issues impacting compliance programs.

Skills

Communication

Critical thinking

Problem-solving

Organizational skills

Education

Bachelor’s degree in business, healthcare, or related area

HS diploma or GED

Job description

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Job Posting Title

Compliance Analyst - Medicare Part B - REMOTE

Job Description

The Compliance Analyst assists in the implementation of Prime’s compliance programs within their designated areas and partners with key internal stakeholders to monitor aspects of compliance and validate policies, procedures, licensure, and program manuals are effectively followed and maintained.

Responsibilities

• Executes compliance procedures and enforces policy governance across the organization to validate requirements are met and that business operations are aligned with expectations of applicable regulatory guidance.
• Develop solutions to moderately complex compliance problems by referring to precedence, policies, and standard operating procedures; escalate issues to Compliance leadership as appropriate.
• Support and, at times, lead the project management efforts of Compliance initiatives.
• Represent the Compliance Department on projects of medium complexity, contracts, or other cross-functional assignments.
• May execute Prime’s compliance programs by facilitating the development, maintenance, and delivery of compliance training, administering the annual conflict of interest process, or reviewing standard operating procedures and policies; may develop annual revision and tracking processes for policies and procedures and participate in department projects and improvement initiatives.
• Research laws, industry guidance, and regulatory issues impacting Prime’s compliance programs or Board of Pharmacy and Department of Insurance filings; document requirements or disciplinary actions and escalate findings as appropriate.
• If supporting licensing efforts, manage regulatory submissions, filings, renewals, notifications, and periodic reports related to licensed functions; compile internal reports, research licensing requirements, respond to information requests, and maintain departmental documentation; may also manage licensing IT applications.
• Perform other duties as assigned.

Education & Experience

• Bachelor’s degree in business, healthcare, or related area, or equivalent experience; HS diploma or GED required.
• At least 2 years of work experience in legal, compliance, or project/program coordination roles in healthcare, PBM, or a highly regulated industry.
• Must be eligible to work in the US without sponsorship.

Additional Qualifications

• Strong communication skills, both written and oral.
• Critical thinking and problem-solving skills.
• Understanding of compliance program principles, practices, and standards.
• Ability to present complex information effectively.
• Ability to influence at all organizational levels.
• Organizational skills to manage multiple projects.

Preferred Qualifications

• Experience in healthcare, PBM, Medicare Part D, Medicaid, or ACA.
• Certifications such as CCEP, CHC, PMP.
• Experience managing licensing applications.

Physical Demands

• Up to 10% travel.
• Prolonged sitting, use of hands, speaking, hearing.
• Occasional standing, walking, lifting up to 25 pounds.
• Vision requirements include close, distance, color, peripheral, depth perception, and focus adjustment.

All employees must adhere to security responsibilities and comply with applicable legal and internal policies.

Potential pay ranges from $59,000 to $94,000 based on experience and skills.

For benefits details, visit our Benefits Page and click on "Benefits at a glance".

Prime Therapeutics is an equal opportunity employer, encouraging diverse candidates to apply. We value inclusivity and provide accommodations as needed.

If you require a reasonable accommodation during the application process, contact Human Resources at 1.866.469.1257 or email [e-mail].