Independent Health — Батыс Нью-Йоркте жұмыс істейтін денсаулық сақтандыру ұйымы және аймақтағы алғашқы медициналық қызмет көрсету ұйымдарының (HMO) бірі. Ол 100-ден астам жоспар, өнім және қызмет арқылы шамамен 355 000 адамға сақтандыру өтемін және оған байланысты қызметтер ұсынады. Компанияның қызмет бағыттарына коммерциялық медициналық сақтандыру, дәріхана жеңілдіктері, Medicare Advantage және өзін-өзі қаржыландыратын медициналық жоспарлар кіреді. Компания өз мәдениетін мүшелер мен қызметкерлерге өз мүмкіндіктерін барынша ашуға көмектесуге бағытталған деп сипаттайды.
Compliance Specialist, Pharmacy Regulations
Support a specialty pharmacy management company’s compliance with regulatory, contractual, privacy and licensing obligations. Research pharmacy rules and coordinate audits, enrollment, renewals, policies and training.
Сипаттама
- Administer and monitor contractual and pharmacy regulatory compliance programs.
- Coordinate contract and regulatory work across Reliance Rx teams, the parent Compliance Department, vendors and regulators.
- Research and assess proposed, pending and current laws and regulations affecting pharmacy operations.
- Advise leaders and work with pharmacy, business development and internal audit teams on regulatory and contractual compliance.
- Monitor federal and state requirements covering pharmacy operations, specialty pharmacy, distribution, 340B, Medicare, Medicaid and HIPAA.
- Track regulatory changes and coordinate implementation of applicable requirements.
- Maintain processes for monitoring contractual and regulatory compliance.
- Contribute to contract review, negotiation, implementation and administration.
- Coordinate contract processing, document management, approvals, signatures and record retention.
- Assist with Medicare and Medicaid enrollment across U.S. states and territories.
- Coordinate pharmacy license renewals, PDMP waivers or zero reporting, licensing and credentialing updates, NCPDP profile renewals and payer credentialing.
- Maintain compliance, privacy and security programs, policies, procedures, metrics, dashboards and tracking tools.
- Coordinate compliance training, onboarding, education, attestations, assessments and awareness activities.
- Support committee work, issue escalation, investigations, corrective action plans and regulatory inquiries.
- Assist with privacy and security monitoring, incident reporting, remediation, audits and government investigations.
- Respond to associate questions about compliance, privacy, security and conflicts of interest.
- Work with operations, data management and internal audit on system access, controls and oversight.
Талаптар
- An associate degree is required; two additional years of experience may substitute for the degree.
- At least three years of experience in compliance, quality assurance or auditing, or program or process management.
- Healthcare experience is preferred.
- Specialty pharmacy or pharmacy experience is preferred.
- Experience with payer and regulatory enrollment and maintenance is preferred.
- Advanced computer and Windows skills are required.
- Experience with Microsoft Office and the ability to learn new software applications.
- Strong research, analytical, writing, drafting, communication, interpersonal, organizational and project management skills, with sound independent judgment.
- Ability to analyze legislation and develop policies and procedures based on regulatory requirements.
- Ability to build and maintain relationships with internal and external stakeholders.
- Knowledge of compliance principles, particularly HIPAA.
- Initiative, creativity and organizational ability.
- Demonstrated examples of Reliance values: Collaborative, Accessible, Results-Oriented, Empowering and Supportive.
- Immigration or work visa sponsorship is not available.
Артықшылықтар
- Eligible for scorecard incentives.
- Full range of benefits.
- Generous paid time off.
- Hybrid work arrangement.