SmithRx is a tech-forward PBM committed to changing the way pharmacy benefits are managed.
Compliance Analyst, Risk, Audit, Monitoring
Location
United States
Posted
30 days ago
Salary
Not specified
Seniority
Senior
Job Description
Job Requirements
- Bachelor’s degree or higher education in healthcare, compliance, or a related 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 oversight or similar experience would be considered
- Direct experience with pharmacy benefits, network, and claims is a bonus
- Certified in Healthcare Compliance (CHC), Certification in Healthcare Privacy Compliance (CHPC), or Certified Compliance and Ethics Professional (CCEP) preferred
- Current, unrestricted clinical or functional business licensure is a bonus (examples: certified pharmacy technician)
- Strong understanding with the seven elements of a highly effective compliance program
- Strong familiarity with PBM-related 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 (Affordable Care 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 leverage resources and stay on focus
- Ability to work independently and within a team environment
- Ability to establish effective collaborative techniques, such as conflict resolution
Benefits
- 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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