Regulatory Compliance Expert Senior

6 days ago

Carson City, Nevada, United States Prime Therapeutics Full time

**Transforming Healthcare through Regulatory Excellence**

At Prime Therapeutics, we are dedicated to making a meaningful difference in people's lives by ensuring seamless access to essential medicines. As a key member of our team, you will play a vital role in driving our mission forward.

**Salary Range:** $74,500 - $111,700 per year (dependent on experience and skills)

**Job Summary:**

The Senior Regulatory Analyst is responsible for leading portions of departmental regulatory review and analysis, external audits and accreditation processes, and participating in committee review meetings within the Commercial, Medicare, Medicaid, and Health Insurance Marketplace for the assigned department.

This position requires expertise in navigating complex regulatory landscapes, staying abreast of industry developments, and ensuring compliance with evolving requirements.

**Responsibilities:**
  • Regulatory Review Committee Meetings: Participate in committees to monitor new regulations and provide necessary updates.
  • National and State Healthcare Regulation Requirements: Monitor national and state healthcare regulation requirements and update stakeholders accordingly.
  • New Business Issues and Opportunities: Take the lead on new business issues and opportunities generated by Government and/or Commercial laws, rules, regulations or guidelines that impact Consumer Delivery.
  • Project Leadership and Governance: Ensure successful implementation and execution of regulatory compliance requirements.
  • Stakeholder Engagement: Establish and maintain engaged relationships with leadership of other functional areas within the corporation.
  • Policies and Procedures: Recommend changes to policies and procedures based on regulatory changes.
  • Audit Liaison: Liaise with Internal Audit and External Audit teams to represent departments in CMS, Client, mock, and vendor audits.
  • Action Plan Development: Review audit feedback, initiate action items related to audit or compliance review findings, and recommend ideas for improvement and summarize action plans.

**Required Skills and Qualifications:**
  • Education: Bachelor's degree in business, finance, health services or related area of study, or equivalent combination of education and/or relevant work experience.
  • Experience: 5 years of successful project management and/or operations management experience related to, or within Pharmacy Benefit Management (PBM) or health insurance.
  • Medicare Part D, Medicaid, and Federal Regulatory Experience: 2 years of experience.
  • Eligibility: Must be eligible to work in the United States without need for work visa or residency sponsorship.

**Benefits:**
  • Health Insurance: Comprehensive health insurance options.
  • Retirement Plan: 401(k) plan with company match.
  • Professional Development: Opportunities for growth and professional development.
  • Diverse Work Environment: Collaborative and inclusive work environment.

**Prime Therapeutics LLC is an equal opportunity employer and welcomes diverse candidates to apply. All qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.

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