Medimpact San Diego , CA 92140
Regulatory Compliance Administrator I
If you're interested in a career within a customer-focused, team-oriented environment that rewards innovation, quality, integrity and collaboration, MedImpact Healthcare Systems, Inc. welcomes your application. MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.
This position is responsible for maintaining an effective compliance program to ensure that MedImpact services are provided in compliance with all laws, regulations, and accreditation standards pertaining to its state licensure, third party administrators, utilization review and management requirements. Works with management for general guidance.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
Obtains, maintains and reviews new licenses, licensing renewals, and reporting requirements for regulatory changes and updates
Researches applicable state and federal laws and agency regulations, works with manager to track applicable legislation/regulation, analyze impact on company, and communicate relevant information to the organization, keeps apprised of new regulatory developments by reviewing regulatory publications and applicable industry trade publications
Interfaces with regulatory authorities on matters relating to compliance with applicable laws or regulations, and prepares correction for review by manager, in response to negative findings of regulatory agencies
Collaborates with manager to participate in internal workgroup compliance initiatives in order to advise and assist company compliance implementation efforts
Works in partnership with manager to monitor and advise on company practices and documentation related to regulatory compliance
Supports HIPAA compliance efforts to ensure policies and procedures are appropriate to meet HIPAA requirements and identifying operational obstacles to compliance and working with other employees to identify and implement solutions
Under management direction, assesses and responds to internal client requests and follows-up onresponses inquiries or complaints from customers or regulatory agencies
Manages assigned projects by planning, researching, and auditing deliverables
Reads, analyzes, and interpret contracts and legal documents, assists company with contractual issues and concerns
Monitors and keeps up-to-date on assigned state's changing healthcare/pharmacy regulations, legal requirements or pending legislation
Education and/or Experience
For consideration candidates will need a Bachelor's degree (or equivalent combination of education and job related experience) in a related field, along with at least three (3) to five (5) years job related experience working in healthcare or managed care regulatory compliance experience, PBM experience preferred.
Microsoft Office Suite and Outlook
Other Skills and Abilities
Working knowledge of HIPAA/HITECH requirements and related company training initiatives strongly preferred
Strong listening skills and ability to convey compliance information, verbally and in writing, in an easy to understand format to employees of organization
This position is eligible for Employee Referral Bonus at Level I
To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.