How Remoteville checks and expires listings
Senior Compliance Professional
Skills
AnalyticsBusinessBusiness AnalyticsBusiness IntelligenceClaims ProcessingData AnalyticsHealth Plan Operations
What the job involves
The main requirements, responsibilities and hiring steps.
Requirements
- Bachelor's degree or 3+ years of pharmacy and compliance experience
- 3+ years of pharmacy operations and/or claims processing experience in a pharmacy setting
- 2+ years of health plan compliance or health plan operations experience
- Experience in pharmacy Coverage Determination and Organization Determination (Part B drugs) functions
- Experience working with regulatory agencies
- Intermediate proficiency in Microsoft Excel Word and PowerPoint
- Knowledge of process improvement and metrics development
- Knowledge of regulations governing health care industries
- Strong communication skills to lead meetings and communicate with business partners
- Ability to work independently manage time effectively and deliver results with minimal supervision
Nice to have
- Analytical
- Detail-oriented
- Collaborative
- Independent
Day to day
- Ensure compliance with government regulations and Medicare Pharmacy and Part D requirements
- Analyze business needs and regulatory factors to advise internal teams and external partners
- Develop monitoring and auditing plans to detect issues and support remediation across pharmacy services
- Build relationships with operational leaders and partners to strengthen compliance controls and reduce risk
Hiring process
- HireVue interview
- Interview process discussion