Sr Compliance Analyst (Medicare/Medicaid) - Remote
Prime Therapeutics · Remote · remote · Posted 1d ago
Undisclosed5–10 yrsfulltimeSourced from
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About this role
Job Posting Title
Job Description
Responsibilities
Minimum Qualifications
Additional Qualifications
Preferred Qualifications
Disclaimer: This job posting and Location has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.
Senior Compliance Analyst (Medicare/Medicaid) - Remote
Job Description
The Senior Compliance Analyst leads compliance initiatives within assigned areas and supports implementation of enterprise compliance programs. This role manages sensitive projects, serves as a subject matter expert, interprets complex requirements, develops executive reporting, and partners across the organization to maintain effective compliance, governance, and licensing processes.
Responsibilities
- Execute compliance procedures and enforce policy governance to validate regulatory reporting and operational requirements are met
- Serve as a compliance subject matter expert and develop solutions to highly complex issues; enhance supporting documentation
- Represent Compliance on complex contracts and cross-functional projects and establish effective stakeholder partnerships
- Lead project management for highly sensitive or complex compliance initiatives
- Prepare clear and accurate compliance records and executive or governance reporting for senior leaders and committees
- Execute and enhance compliance programs, training, conflict of interest, policy governance, and cyclical compliance processes
- Research and interpret laws, guidance, regulatory issues, and filing requirements; document and escalate findings
- Manage assigned licensing submissions, filings, renewals, reporting, source documentation, procedures, and tools
- Other duties as assigned
Minimum Qualifications
- Bachelor's degree in business, healthcare, or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma from an accredited school or equivalent GED required
- 5 years of progressive work experience in legal or compliance related roles for a healthcare or PBM organization, or other highly regulated industry, including experience with Medicare, Medicaid, and the Affordable Care Act (ACA)
- Must be eligible to work in the United States without the need for work visa or residency sponsorship
Additional Qualifications
- Exceptional written and verbal communication skills
- Critical thinking and problem-solving skills for highly complex situations
- Comprehensive understanding of effective compliance program principles, practices, standards, industry challenges, and emerging approaches
- Ability to present complex information and influence stakeholders at all organizational levels
- Advanced organization and analytical skills with ability to manage multiple projects simultaneously
Preferred Qualifications
- PBM or healthcare experience
- Certified Compliance and Ethics Professional (CCEP) or Certified in Healthcare Compliance (CHC)
- Project Management Professional (PMP)
- Medicare Part D, Medicaid, and/or Affordable Care Act experience
- Advanced degree in a related area of study, such as Juris Doctor
- Licensing application maintenance, tracking, renewal, and submission experience
Disclaimer: This job posting and Location has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.
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Skills
juris doctoranalytical thinkinghealthcare compliancesubject matter expertMedicaidmedicaresecurity controlsPharmacyHealthcareRegulatory ReportingProject ManagementPMPResearchCommunication SkillsmaintenanceLegalcompliance
About Prime Therapeutics
Prime Therapeutics
Eagan
US
About
Prime Therapeutics is a pharmacy benefit management company that partners with health plans, employers, and government programs to provide cost-effective prescription drug services. It focuses on improving patient outcomes by managing medication access, affordability, and adherence. Through integrated solutions and collaborative care, Prime Therapeutics helps millions of members optimize their pharmacy benefits while reducing overall healthcare costs.
Industries
Health CarePharmaceutical
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