Compliance Analyst

Back to jobs New Compliance Analyst Remote Apply Who We Are: SmithRx 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 next-generation 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, SmithRx has a solution that is resonating with clients all across the country. We pride ourselves for our mission-driven and collaborative culture that inspires our employees to do their best work. We believe 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: Integrity: Our purpose guides our actions and gives us confidence in the path ahead. With unwavering honesty and dependability, we embrace the pressure of challenging the old and exemplify ethical leadership to create the new. Courage: We face continuous challenges with grit and resilience. We embrace the discomfort of the unknown by balancing autonomy with empathy, and ownership with vulnerability. We boldly challenge the status quo to keep moving forward—always. Together: The success of SmithRx reflects the strength of our partnerships and the commitment of our team. Our shared values bind us together and make us one. When one falls, we all fall; when one rises, we all rise. Job Summary: We are looking for a Compliance Analyst to assist in all operational aspects of implementing a highly-effective compliance program in a dynamic PBM regulatory landscape. In this role, you will assist and lead initiatives which prevent, detect, or correct noncompliance using the key seven elements of a compliance program. You will work closely with Compliance leadership, Legal, and Regulatory Counsel to support our mission. We are looking for someone who is enthusiastic about building and supporting programs that impact pharmacy and healthcare at a high-growth healthcare technology company, bringing strong ethics, integrity, and solid interpersonal skills.  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 visit any of the SmithRx offices, including the home office in San Francisco, California. In order to be eligible for this position applicants must be based in one of the following states : Arkansas, Arizona, California, Colorado, Florida, Georgia, Kansas, Minnesota, Missouri, Nevada, North Carolina, South Carolina, Ohio, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin. What you will do: Report to Compliance leadership, playing a significant role in the development of the Compliance Program Use analytical skills and compliance knowledge to be a thought leader and effectively reduce risks to our organization Build and maintain positive and strategic relationships with internal and external stakeholders  Support the open-door posture for reporting and detecting issues of compliance  Assist in the development of materials and reporting metrics for leadership and applicable oversight committees  Support the Compliance Program workplan and risk assessments  Ensure document retention standards and evidence of compliance activities are maintained across our organization Assist in the review, development, and completion of regulatory reporting or filings as needed Provide or assist in informal or formal training and education related to regulatory and legal requirements such as policies and procedures, regulatory implementations, and more Work with Legal and Compliance leadership to interpret regulations and distribute related guidance to impacted stakeholders through SmithRx’s regulatory change and distribution management program Design and perform readiness testing  Investigate potential or reported issues of non-compliance, state-based complaints, and concerns outlined in regulator inquiries Assist in internal and external audit and monitoring activities, analyzing outcomes and ensuring detected issues are referred for remediation  Analyze data and performance outcomes with relevant business leads and/or delegates to ensure compliance with requirements, escalating issues to Compliance leadership Identify, document, and escalate new or increasing risks for the purposes of maintaining accurate risk assessments and subsequent mitigation plans Perform root-cause analysis with issues of non-compliance Ensure proper engagement and documentation with impacted parties so that mitigation activities are executed accurately and timely so that repeat non-compliance is avoided Other duties as assigned What you will bring to SmithRx: Education and Experience: Bachelor’s degree or higher education in business or 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, health plan and pharmacy operations oversight 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 Current, unrestricted clinical or functional business licensure is a bonus (examples: certified pharmacy technician, paralegal, LPN in state of service, analytics, etc.) Hard and Soft Skills: Strong familiarity with the seven elements of a highly effective compliance program Strong familiarity with pharmacy operations and healthcare benefits Strong familiarity with ERISA governed healthcare benefits and government-funded healthcare programs, such as Healthcare Exchange Marketplace (Affordable Care Act) and Medicare preferred (compliance standards imposed upon Delegated and Downstream Entities (DDEs)/ First Tier, Downstream and Related (FDR) entities) Familiarity with PBM-related healthcare operations and/or clinical concepts, practices and procedures is preferred, or similar health plan knowledge will be considered Working knowledge of data analytics and ability to produce meaningful insight and solutions with sound business judgement  Proven knowledge of internal and external audit functions and procedures Ability to conduct research and analysis of Federal, State, and relevant industry regulatory and enforcement  Demonstrated professional communication skills, to include proper grammar usage, document structure, and business writing to audiences including but not limited to internal Leadership at all levels, internal and external Legal Counsel, Corporate Compliance, State and Federal Regulators  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 What SmithRx 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  12 Paid Holidays Wellness Benefits Commuter Benefits  Paid Parental Leave benefits Employee Assistance Program (EAP) Well-stocked kitchen in office locations Professional development and training opportunities Create a Job Alert Interested in building your career at SmithRx? 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