Sr. Director, Medical Pharmacy Compliance - Remote
Company: Prime Therapeutics
Location: Baton Rouge
Posted on: January 24, 2023
Job Description:
Our work matters. We help people get the medicine they need to
feel better and live well. We do not lose sight of that. It fuels
our passion and drives every decision we make.Job Posting TitleSr.
Director, Medical Pharmacy Compliance - RemoteJob Description
SummaryThis position is responsible for assisting with the
implementation and administration of the Magellan Pharmacy
Compliance Program.Job Description
- Assists with the implementation of the Magellan Pharmacy
Compliance Program, and educates the management team and staff
about compliance and the appropriate components of the compliance
program and the Office of Inspector General (OIG) Work Plan.
- Provides guidance to operations units in the development and
implementation of policies and procedures relevant to Magellans
Medicare and Pharmacy Benefit Management (PBM) Services.
- Provides regular reports to the VP Pharmacy and Medicare
Compliance Officer regarding the effectiveness of specific
components of the Magellan Rx Compliance Program including
remediation efforts and monitoring of corrective action plans.
- Implements appropriate program controls to prevent, detect, and
correct potential issues of fraud, waste and abuse.
- Reviews operational policies and procedures to ensure
compliance with CMS regulations and state and federal laws.
- Responsible for organizational compliance with HPMS notices,
CMS and regulatory guidance, as appropriate.
- Provides guidance in response to operational compliance
questions/concerns.
- Provides consultative leadership and directs 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.
- Assists with the development and implementation of a metrics
program to monitor processes of internal operations and First Tier,
Downstream and Related Entities (FDRs) for compliance with
applicable CMS regulations, guidance and appropriate federal and
state laws.
- Reviews potential issues of non-compliance, report to Medicare
Compliance Officer and coordinate investigation, remediation and
provides appropriate guidance to operational areas.Responsibilities
- 8+ years Healthcare Compliance experience with extensive
experience with Medicare products, including Medicare Part D.
- Strong verbal and written communication skills.
- Working knowledge Microsoft Office Product Suite.Work
ExperienceWork Experience - Required:Compliance, Medicare, Medicare
Part D (MedD), SupervisoryWork Experience -
Preferred:EducationEducation - Required:BachelorsEducation -
Preferred:CertificationsCertifications - Required:Certifications -
Preferred:Potential pay for this position ranges from $93,955.00 -
$159,725.00 based on location, experience and skills.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 an Equal Opportunity Employer. We
encourage diverse candidates to apply and all qualified applicants
will receive consideration for employment without regard to race,
color, religion, sex (including pregnancy), sexual orientation,
gender identity or expression, genetic information, marital status,
family status, national origin, age, disability, veteran status, or
any other legally protected class under federal, state, or local
law.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 an Equal Opportunity Employer. We
encourage diverse candidates to apply and all qualified applicants
will receive consideration for employment without regard to race,
color, religion, sex, sexual orientation, gender identity, national
origin, disability, or veteran status. 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.
Keywords: Prime Therapeutics, Baton Rouge , Sr. Director, Medical Pharmacy Compliance - Remote, Executive , Baton Rouge, Louisiana
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