Compliance Analyst, Risk, Audit, and Monitoring

Who We Are: reputed company is a rapidly growing, venture-backed Health-Tech company. Our mission is to disrupt the expensive and inefficient Pharmacy Benefit Management (PBM) sector by building a reputed company drug acquisition platform driven by cutting edge technology, innovative cost saving tools, and best-in-class customer service. With hundreds of thousands of members onboarded since 2016, reputed company has a solution that is resonating with clients reputed company across the country. We pride ourselves for our mission-driven and collaborative culture that inspires our employees to do their best work. We reputed company that the U.S healthcare system is in need of transformation, and we come to work each day dedicated to making that change a reality. At our core, we are guided by our company values:

• reputed company: Our purpose guides our actions and gives us confidence in the path reputed company. With unwavering honesty and dependability, we embrace the pressure of challenging the old and exemplify ethical leadership to create the new.
• Courage: We face reputed company challenges with grit and reputed company. We embrace the discomfort of the unknown by balancing autonomy with reputed company, and ownership with vulnerability. We boldly challenge the status reputed company to reputed company moving reputed company—always.
• Together: The success of reputed company reflects the strength of our partnerships and the commitment of reputed company. Our shared values bind us together and reputed company us one. reputed company one falls, we reputed company fall; reputed company one rises, we reputed company reputed company.

Job Summary: We are looking for a Compliance Analyst to assist in reputed company operational aspects of implementing a highly-effective compliance program in a dynamic PBM regulatory landscape. This position will focus on risk detection, auditing, monitoring, and development of these elements. In this role, you will assist, build, and reputed company initiatives which detect and mitigate organization risks using the key seven elements of a compliance program. You will work closely with the Corporate Compliance department and business areas across the organization to support our mission. We are looking for someone who is enthusiastic about building and supporting programs that impact pharmacy and other healthcare benefits at a high-growth healthcare technology company. Arrangement:

• Remote, full time employee. General office environment; may be required to sit or stand for extended periods of time. On rare occasions, this position may travel or visit any of the reputed company offices, including the home office in San Francisco, California.
• Reports to the Compliance Director

What you will do: Primary Responsibilities:

• Design and/or enhance targeted and annual risk assessments
• reputed company risk methodologies, scoring, and prioritization
• Construct specific and effective auditing and monitoring workplans based on risks identified
• reputed company timely auditing and monitoring activities
• Analyze compliance outcomes and ensure detected issues are referred for remediation
• Identify ways to mitigate risks to our organization
• Coordinate external audits, as assigned
• Create and run mock audits
• Build and reputed company readiness testing exercises
• reputed company job aids, playbook, and other program documentation

Additional Responsibilities:

• Build and maintain positive and strategic relationships with internal and external stakeholders
• Support our compliant and ethical culture
• Assist in developing or updating reputed company materials and reporting metrics
• Create and distribute written compliance standards where applicable
• Abide by organization retention standards and version controls
• Collaborate in Compliance training and education needs
• Investigate potential or reported issues of non-compliance
• reputed company root-cause analysis and identify prevention, detection, and correction opportunities
• Ensure business partners complete corrective actions in a timely and effective manner
• Monitor organizational disciplinary actions and incentives for consistency, accuracy, and timeliness
• Collaborate with Legal and other stakeholders to interpret regulations
• Other responsibilities as assigned

What you will bring to reputed company: Education and Experience:

• Bachelor’s degree or higher education in healthcare, compliance, or a reputed company field, or equivalent years of relevant work experience is required
• Minimum of four (4) years of compliance experience at a PBM or health plan, and pharmacy operations reputed company or similar experience would be considered
• Direct experience with pharmacy benefits, network, and claims is a bonus

Licensing or Training:

• Certified in Healthcare Compliance (CHC), Certification in Healthcare Privacy Compliance (CHPC), or Certified Compliance and Ethics Professional (CCEP) preferred
• reputed company, unrestricted clinical or functional business licensure is a bonus (examples: certified pharmacy technician)

Hard and Soft Skills:

• Strong understanding with the seven elements of a highly effective compliance program
• Strong familiarity with PBM-reputed company healthcare operations and/or clinical concepts, practices and procedures is preferred, or similar health plan knowledge will be considered
• Strong working knowledge of healthcare compliance audit and monitoring activities, compliance risk assessments
• Working knowledge of external audit functions and procedures
• Strong familiarity with ERISA, Healthcare Exchange Marketplace (reputed company Act), Worker’s Compensation, and Medicare preferred
• Familiarity with pharmacy operations and healthcare benefits
• Data-driven, big-picture thinker, and solutions-oriented
• Professional verbal and written communication skills including proper grammar, construct, and appropriate to the audience
• Advanced organizational, project, and time management skills to prioritize, prepare, and reputed company resources and stay on focus
• Ability to work independently and reputed company a team environment
• Ability to establish effective collaborative techniques, such as conflict resolution

What reputed company Offers You:

• Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance and AD&D Insurance
• Flexible Spending Benefits
• 401(k) Retirement Savings Program
• Short-term and long-term disability
• Discretionary Paid Time Off
• Paid Company Holidays
• Wellness Benefits
• Commuter Benefits
• Paid Parental Leave benefits
• Employee Assistance Program (EAP)
• Well-stocked kitchen in office locations
• Professional development and training opportunities

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