Pharmacy Medicare Part D Compliance Specialist

4 days ago


Albuquerque, New Mexico, United States Presbyterian Healthcare Services Full time
Job Title: Pharmacy Medicare Part D Compliance Specialist

We are seeking a highly skilled Pharmacy Medicare Part D Compliance Specialist to join our team at Presbyterian Healthcare Services. As a key member of our pharmacy team, you will play a critical role in ensuring compliance with Medicare Part D regulations and guidelines.

Key Responsibilities:
  • Assist in the review and interpretation of new regulatory requirements and monitoring of internal departmental processes and procedures.
  • Play a key role in assuring preparedness for internal and external audits, including acting as audit lead or co-lead for assigned areas.
  • Monitor internal and external corrective action plans related to CMS Part D regulations or requirements.
  • Develop effective metrics and controls to detect compliance issues or system errors.
  • Assure that reports and files submitted to CMS are accurate and submitted by required deadlines.
  • Provide education to staff regarding Part D compliance and program updates.
Requirements:
  • High school diploma or GED required, plus 5 years of pharmacy experience.
  • Prefer 3 years of experience in a managed care pharmacy environment.
  • Strong organizational skills and ability to understand and interpret regulatory requirements.
  • Proficient user in business productivity and reporting tools.
Why Work at Presbyterian?

As an organization, we are committed to improving the health of our communities. We offer a comprehensive benefits package, including medical, dental, vision, short-term and long-term disability, group term life insurance, and other optional voluntary benefits. Our Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being.

We value our employees' differences and find strength in the diversity of our team and community. At Presbyterian, it's not just what we do that matters - it's how we do it. We strive to create a work environment that is inclusive, respectful, and supportive of all employees.



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