Pharmacy Compliance Analyst - Hybrid Role & Audits

Wellmark Blue Cross and Blue Shield; Des Moines (IA); Hybrid; USD 80,000 - 100,000; Full time

Job summary

Wellmark Blue Cross Blue Shield is seeking a Pharmacy Compliance Analyst to join our Pharmacy Services team in Des Moines. The hybrid role collaborates with Legal, Regulatory Compliance, and Pharmacy Quality Assurance to ensure regulatory compliance and support audits.

You will research, track, and report regulatory inquiries, coordinating with peers to remediate issues and drive compliance across the organization. Strong project management and communication skills are essential.

Qualifications

• Bachelor’s degree or direct and equivalent work experience.
• 4+ years of health insurance, health care, or related industry experience with understanding rules and policies.
• Strong written and verbal communication skills and ability to manage multiple priorities.

Responsibilities

• Manage day-to-day regulatory compliance related to pharmacy and coordinate with leadership and staff.
• Support oversight of exchange tasks including CMS audits and audit findings.
• Serve as NCQA and HEDIS expert, gathering evidence and ensuring compliance.
• Submit MCAS data for annual submission to the Division of Insurance.
• Develop and update pharmacy policies and procedures for compliance.

Skills

Microsoft Office

Strong communication

Regulatory compliance

Education

Bachelor's degree or equivalent

Tools

HROR

Job description

Wellmark Blue Cross Blue Shield is seeking a Pharmacy Compliance Analyst to join our Pharmacy Services team in Des Moines. The hybrid role collaborates with Legal, Regulatory Compliance, and Pharmacy Quality Assurance to ensure regulatory compliance and support audits.

You will research, track, and report regulatory inquiries, coordinating with peers to remediate issues and drive compliance across the organization. Strong project management and communication skills are essential.