Compliance Analyst -Medicare Part B- REMOTE

Lensa; Hartford (CT); Remote; USD 59,000 - 94,000; Full time

Job summary

Join a forward-thinking organization as a Compliance Analyst focusing on Medicare Part B. In this remote role, you'll drive compliance initiatives, ensuring adherence to regulatory standards while collaborating with key stakeholders. Your expertise will help shape compliance programs, manage regulatory submissions, and facilitate training efforts. This is an exciting opportunity to make a meaningful impact in the healthcare sector, where your contributions will help ensure that essential services are delivered effectively and in accordance with laws and regulations. If you're passionate about compliance and looking for a role that values your skills, this position is for you.

Qualifications

• 2+ years of experience in legal, compliance, or project coordination roles.
• Strong understanding of compliance program principles and practices.

Responsibilities

• Execute compliance procedures and enforce policy governance across the organization.
• Manage regulatory submissions, filings, and maintain departmental documentation.

Skills

Communication Skills

Critical Thinking

Problem-Solving Skills

Organizational Skills

Education

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

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.
• Facilitate the development, maintenance, and delivery of compliance training, administer the annual conflict of interest process, and review standard operating procedures and policies regularly. Develop annual revision and tracking processes for policies and procedures.
• 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.
• Manage regulatory submissions, filings, renewals, notifications, and periodic reports related to licensed functions (e.g., PBM, Third Party Administrator, Utilization Review Organization, etc.); 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 field, or equivalent experience; HS diploma or GED required.
• At least 2 years of work experience in legal, compliance, or project coordination roles in healthcare, PBM, or other regulated industries.
• Must be eligible to work in the U.S. without sponsorship.

Additional Qualifications

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

Preferred Qualifications

• Experience in healthcare or PBM.
• Knowledge of Medicare Part D, Medicaid, ACA.
• Certifications such as CCEP, CHC, PMP.
• Experience with licensing processes and application management.

Physical Demands

• Travel up to 10%.
• Constantly sit, handle, talk, and hear.
• Frequently reach with hands and arms.
• Occasionally stand, walk, stoop, kneel, crouch.
• Lift/move up to 25 pounds occasionally.
• Visual requirements include close, distance, color, peripheral, and depth perception.

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.

See our Benefits Page for more details.

Prime Therapeutics is an equal opportunity employer, encouraging diverse candidates to apply. All qualified applicants will receive consideration without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, disability, age, veteran status, or other protected classes under law.

We welcome applicants with different backgrounds, experiences, and abilities, including those requiring reasonable accommodations.

If you need a reasonable accommodation, contact Human Resources at 1.866.469.1257 or email [e-mail].