Pharmacy Compliance Analyst — Hybrid

Wellmark; Des Moines (IA); Hybrid; USD 85,000 - 110,000; Full time

Job summary

Wellmark is seeking a Pharmacy Compliance Analyst to join our Pharmacy Services team in Des Moines. You will partner with Legal, Regulatory Compliance, Pharmacy Quality Assurance to ensure regulatory compliance and respond to audit requests.

You are analytical, organized, and proactive, with healthcare compliance experience. This role offers a hybrid schedule with in-office days in Des Moines and remote options.

Qualifications

• Bachelor’s degree or equivalent work experience.
• 4+ years in health insurance, health care, or related industry.
• Ability to interpret regulatory guidelines and assess business impact.
• Strong documentation and communication skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Willingness to learn and stay current on compliance practices.

Responsibilities

• a. Manage day-to-day pharmacy regulatory compliance per established policies and procedures.
• b. Support pharmacy team in oversight of CMS audits and related documentation.
• c. Serve as the NCQA expert, gather evidence for annual submission and audits.
• d. Serve as the HEDIS expert, updating data for annual audit and accreditation.
• e. Gather MCAS data for annual submission to Division of Insurance.
• f. Ensure policies are reviewed/updated annually; develop new policies as needed.
• g. Support corporate compliance and ethics; act as liaison and drive compliance.
• h. Attend pharmacy team meetings to share compliance updates and projects.
• i. Collaborate with Compliance staff on Medicare Advantage PDP compliance matters.
• j. Participate in audits; research and provide data for internal/external audits.
• k. Other duties as assigned.

Skills

Strong verbal and writtencommunication

Analytical skills

Project management

Collaboration

Time management

Microsoft Office

Education

Bachelor’s degree or direct and equivalent work experience

Tools

Microsoft Office

Job description

Wellmark is seeking a Pharmacy Compliance Analyst to join our Pharmacy Services team in Des Moines. You will partner with Legal, Regulatory Compliance, Pharmacy Quality Assurance to ensure regulatory compliance and respond to audit requests.

You are analytical, organized, and proactive, with healthcare compliance experience. This role offers a hybrid schedule with in-office days in Des Moines and remote options.