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- Obtains, maintains and reviews new licenses, licensing renewals, and reporting requirements for regulatory changes and updates
- Researches applicable state and federal laws and agency regulations, works with manager to track applicable legislation/regulation, analyze impact on company, and communicate relevant information to the organization, keeps apprised of new regulatory developments by reviewing regulatory publications and applicable industry trade publications
- Interfaces with regulatory authorities on matters relating to compliance with applicable laws or regulations, and prepares correction for review by manager, in response to negative findings of regulatory agencies
- Collaborates with manager to participate in internal workgroup compliance initiatives in order to advise and assist company compliance implementation efforts
- Works in partnership with manager to monitor and advise on company practices and documentation related to regulatory compliance
- Supports HIPAA compliance efforts to ensure policies and procedures are appropriate to meet HIPAA requirements and identifying operational obstacles to compliance and working with other employees to identify and implement solutions
- Under management direction, assesses and responds to internal client requests and follows-up onresponses inquiries or complaints from customers or regulatory agencies
- Manages assigned projects by planning, researching, and auditing deliverables
- Reads, analyzes, and interpret contracts and legal documents, assists company with contractual issues and concerns
- Monitors and keeps up-to-date on assigned state's changing healthcare/pharmacy regulations, legal requirements or pending legislation
- Working knowledge of HIPAA/HITECH requirements and related company training initiatives strongly preferred
- Strong listening skills and ability to convey compliance information, verbally and in writing, in an easy to understand format to employees of organization
- Medical / Dental / Vision / Wellness Programs
- Paid Time Off / Company Paid Holidays
- Incentive Compensation
- 401K with Company match
- Life and Disability Insurance
- Tuition Reimbursement
- Employee Referral Bonus
Regulatory Compliance Administrator II - San Diego, United States - MedImpact
Description
Exemption Status:United States of America (Exempt)
$82,074 - $110,800 - $139,526
"Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate."
MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team
Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.
At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing
solutions
that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution
Job Description
Regulatory Compliance Administrator I or II
Regulatory Compliance Administrator I: $68,860 - $92,100 - $115,340
Regulatory Compliance Administrator II: $82,074 - $110,800 - $139,526
Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.
This position is not eligible for Sponsorship.
Position Summary
The Regulatory Compliance Administrator is responsible for maintaining an effective compliance program to ensure that MedImpact services are provided in compliance with all laws, regulations, and accreditation standards pertaining to its state licensure, third party administrators, utilization review and management requirements. This position also works with management for general guidance.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
Level I
For consideration candidates will need a Bachelor's degree (or equivalent combination of education and job related experience) in a related field, along with at least three (3) to five (5) years job related experience working in healthcare or managed care regulatory compliance experience, PBM experience preferred.
Level II
For consideration candidates will need a Bachelor's degree (or equivalent combination of education and experience) in a related field, along with at least five (5) to seven (7) plus years' job related experience working in pharmacy benefit management, healthcare or managed care regulatory compliance.
Computer Skills
Microsoft Office Suite and Outlook
Other Skills and Abilities
MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego,
California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.
Equal Opportunity Employer, Male/Female/Disabilities/Veterans
OSHA/ADA:
To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Disclaimer:
The above
statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.