Compliance Analyst - Corrections
New
S
SmithRxHealth-Tech
RemoteFull-TimeMiddle
Salary$89,300 — $126,000 USD (Varies by location: Zone A: $107,100-$126,000; Zone B: $98,200-$115,500; Zone C: $89,300-$105,000)
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Job Details
- Experience
- Minimum of four (4) years of compliance experience at a PBM or health plan
- Required Skills
- Project ManagementCompliance
Requirements
- Bachelor’s degree or higher in healthcare, compliance, or a related field, or equivalent years of relevant work experience
- Minimum of four (4) years of compliance experience at a PBM or health plan
- Strong understanding of the seven elements of a highly effective compliance program
- Working knowledge of healthcare compliance program corrective actions
- Working knowledge of external audit functions and procedures
- Strong familiarity with PBM-related healthcare operations, clinical concepts, practices, and procedures
- Familiarity with pharmacy operations and healthcare benefits
- Ability to work independently and within a team environment
- Advanced organizational, project, and time management skills
Responsibilities
- Design and/or enhance corrective action processes
- Assess and prioritize corrective action referrals
- Initiate corrective actions such as corrective action plans and warning letters
- Collaborate with business stakeholders to perform root cause analysis and identify prevention, detection, and correction opportunities
- Ensure business partners complete corrective actions in a timely and effective manner
- Develop job aids, playbooks, and other program documentation
- Investigate potential or reported issues of non-compliance
- Monitor organizational disciplinary actions and incentives for consistency, accuracy, and timeliness
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