Compliance Analyst - Corrections

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. This position will focus on successful remediation of identified non-compliance with regulatory requirements and company policies and procedures. 

In this role, you will assist, build, and lead initiatives which correct and mitigate organization risks using the key seven elements of a compliance program. You will work closely with the Corporate Compliance department and business areas across the organization to support our mission. 

We are looking for someone who is enthusiastic about building and supporting programs that impact pharmacy and other healthcare benefits at a high-growth healthcare technology company. This is a remote, full time position and you may be required to sit or stand for extended periods of time. On rare occasions, this position may travel or visit any of the SmithRx offices, including the home office in San Francisco, California. This position reports to the Compliance Director.

What you will do:

Primary Responsibilities:

• Design and/or enhance corrective action process
• Assess and prioritize corrective action referrals 
• Initiate corrective actions (e.g., corrective action plans, warning letters)
• Collaborate with business stakeholders to perform root cause analysis
• Collaborate with business stakeholders to identify prevention, detection, and correction opportunities
• Ensure business partners complete corrective actions in a timely and effective manner
• Identify ways to mitigate risks to our organization 
• Develop job aids, playbook, and other program documentation

Additional Responsibilities:

• Build and maintain positive and strategic relationships with internal and external stakeholders 
• Support our compliant and ethical culture 
• Assist in developing or updating oversight materials and reporting metrics
• Create and distribute written compliance standards where applicable
• Abide by organization retention standards and version controls
• Collaborate in Compliance training and education needs
• Investigate potential or reported issues of non-compliance
• Monitor organizational disciplinary actions and incentives for consistency, accuracy, and timeliness
• Collaborate with Legal and other stakeholders to interpret regulations 
• Other responsibilities as assigned

What you bring:

Education and Experience:

• Bachelor’s degree or higher education in healthcare, compliance, or a 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, 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)

Hard and Soft Skills:

• Strong understanding with the seven elements of a highly effective compliance program
• Strong familiarity with PBM-related healthcare operations and/or clinical concepts, practices and procedures is preferred, or similar health plan knowledge will be considered
• Strong working knowledge of healthcare compliance program corrective actions
• Working knowledge of external audit functions and procedures
• Strong familiarity with ERISA, Healthcare Exchange Marketplace (Affordable Care Act), Worker’s Compensation, and Medicare preferred
• Familiarity with pharmacy operations and healthcare benefits
• Data-driven, big-picture thinker, and solutions-oriented  
• Professional verbal and written communication skills including proper grammar, construct, and appropriate to the audience 
• 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
• Ability to establish effective collaborative techniques, such as conflict resolution

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

Requires a bachelor's degree or equivalent experience, 4+ years of PBM or health plan compliance experience, healthcare operations knowledge, and strong corrective action, audit, communication, and organizational skills.

Key Responsibilities

• designing corrective actions
• investigating noncompliance
• mitigating organizational risks

Job Details

• Category: Legal and Compliance
• Seniority: Mid Level
• Commitment: Full Time
• Workplace: Remote — United States
• Salary: USD 89,300 – 126,000 / year
• Languages: English

Benefits

• Generous paid time off
• Retirement plan
• Generous parental leave

About SmithRx

A health technology company providing a technology-driven drug acquisition platform for pharmacy benefit management. — Industry: Healthcare