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Job Posting Title

Compliance Principal - Remote

Job Description

The Compliance Principal is responsible for the successful execution of key components and elements of Prime’s corporate compliance program. This position works closely with designated business areas, legal, and other internal stakeholders on the development, implementation, and monitoring of compliance initiatives as well as identifying changing laws and regulations or client contractual compliance obligations, interpreting the impact and managing solutions for designated functions. This role supports and partners directly with compliance department leadership and Prime’s Chief Compliance Officer.

Responsibilities

• Promote awareness and engagement in organizational culture of compliance and ethics.

• Serves as a compliance subject matter expert, providing strategic guidance and second line of defense oversight to improve organizational-wide processes and establish, measure, and improve compliance program practices.

• Proactive identification and resolution of complex business and compliance issues, while aligning with organizational goals and minimizing friction and maximizing productivity and impact.

• Serve as a trusted partner working cross functionally with operational business teams building a deep understanding of how their teams work, their needs and how compliance requirements can be operationalized in their teams and work.

• Leads compliance program process execution in assigned function to ensure organizational obligations are met and business operations are aligned with applicable laws and regulatory guidance.

• Provide consultative leadership and direct efforts to communicate compliance program components, including training and education materials designed to promote understanding of compliance elements, regulations and laws, and consequences of non-compliance.

• Lead successful implementation of projects and initiatives, including developing, leading and/or oversight of large, complex initiatives that may be function-specific and/or involve multiple business areas and partners.

• Monitor changes to laws, regulatory enforcement trends and industry landscape to stay ahead of evolutions, trends and best practices to inform business strategy and compliance program strategic plan.

• Develop, track, and produce data metric reports demonstrating compliance program effectiveness.

• Represent Prime, the Compliance program and its interests in external interactions with trade associations, State and Federal regulators, consulting agencies and accrediting bodies.

• Provide direct, or indirect leadership to other compliance professionals, consistently role modeling Prime’s employee and leadership expectations.

• Serves as a consultant to management on major matters pertaining to laws and regulations, policies, plans and objectives and provides Subject Matter Expertise in their areas of focus (Commercial/HIM and Government Programs).

• Leads the Regulatory Inquiry and Response efforts and supports legal and government affairs in hearings or regulator communications.

• Independently researches, determines root cause and collaborates with others to resolve complex business and technical issues and regulatory inquiries.

• Provides prompt and thorough resolution for client and/or member satisfaction.

• Other duties as assigned

Minimum Qualifications

• Bachelor’s degree in business, healthcare, or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required

• 8 years of progressive work experience in legal or compliance related roles for a healthcare or Pharmacy Benefit Management organization, or within a highly regulated industry, including experience with Medicare, Medicaid, and the Affordable Care Act (ACA)

• Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

• Strong interpersonal communication skills, including team leadership, conflict resolution, listening, establishing rapport and effectively influence at all levels within an organization, and leading meetings with various leaders in an organization.

• Well-developed organization, analytical, interpretative and time management skills with the ability to effectively work on multiple projects simultaneously.

• Expert level understanding of effective compliance program principles, concepts, practices and standards; full breadth of knowledge around industry best practices and challenges and experience developing new concepts, techniques, standards and programs to support an organization’s compliance priorities.

• Demonstrated ability to apply critical thinking skills to proactively identify issues and problem solve through the most complex compliance situations.

• Demonstrated oral and written communication skills, including ability to effectively interpret and present complex information to a wide variety of audiences.

• Ability to simultaneously manage multiple projects within strict timelines, under pressure.

• Working knowledge of Medicare Part D, Medicaid, state healthcare product or program related regulations and/or Health Insurance Marketplace guidance

• Experience identifying opportunities for improvement and leading the implementation of process changes.

• Strong problem solving and decision-making skills.

• Effective use of interpersonal skills including the ability to handle conflict, promote teamwork, display empathy, and maintain a positive attitude.

• Proficient in Microsoft Office

Preferred Qualifications

• Certified Compliance and Ethics Professional (CCEP) or Certified in Healthcare Compliance (CHC)

• Advanced degree in relevant discipline (JD, MBA, MHA, etc.)

Minimum Physical Job Requirements

• Ability to travel up to 20% of the time

• Constantly required to sit, use hands to handle or feel, talk and hear

• Frequently required to reach with hands and arms

• Occasionally required to stand, walk and stoop, kneel, and crouch

• Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds

• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Reporting Structure

• Reports a Director in the Compliance department

Potential pay for this position ranges from $109,000.00 - $174,000.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https://www.primetherapeutics.com/careers/benefits/) and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.

Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.

If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.