Regulatory Compliance Manager
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.
The Regulatory Compliance Manager will be responsible for supporting MedImpact’s Corporate Compliance Program, including providing support and maintenance of MedImpact’s HIPAA compliance program with a focus on privacy and security. This individual will manage and oversee regulatory compliance activities ensuring MedImpact services are provided in accord with applicable laws, regulations, and accreditation standards pertaining to federal and state regulatory and licensure requirements.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
- Manages requests received from vendors, clients, regulatory authorities, MedImpact subsidiaries, and internal customers relating to MedImpact’s regulatory compliance initiatives, licensing and related processes
- Addresses and oversees subsidiaries’ and HIPAA Administrative Simplification compliance efforts independently and in collaboration with the Corporate Compliance Officer, HIPAA Privacy Officer, and HIPAA Security Officer
- Ensures company HIPAA policies and procedures are appropriate to meet HIPAA requirements, identifies operational obstacles to compliance, and works withother employees to identify and implement solutions
- Serves as a HIPAA Compliance Subject Matter Expert (SME)
- Researches applicable state and federal laws and agency regulations, tracks applicable legislation/regulations, analyzes impact on company and subsidiaries, and communicates relevant information to the organization
- Stays up-to-date with new regulatory developments, assigned state’s changing healthcare/pharmacy regulations, legal requirements, and pending legislation by reviewing regulatory publications and applicable industry trade publications
- Obtains, maintains, and reviews new licenses, licensing renewals, and reporting requirements for regulatory changes and updates, as well as participates in MedImpact’s subsidiary licensing oversight efforts
- Interfaces with regulatory authorities on matters relating to compliance with applicable laws or regulations, and prepares correction in response to negative findings of regulatory agencies
- Responsible for writing applicable regulatory compliance policy and procedure documentation, identifying need, and participating in internal workgroup compliance initiatives to advise and assist company compliance implementation efforts
- Maintains expertise in assigned research topic(s) to support identified company compliance needs and monitors/advises on company practices and documentation related to regulatory compliance
- Held accountable to independently (or with minimal management supervision) accurately assess and respond to internal and external requests and/or complaints from external customers
- Acts as an internal liaison to support regulatory audits
- Facilitates and handles regulatory audits on behalf of the department for external clients
- Manages assigned projects by planning, researching, and auditing deliverables
- Reads, analyzes, and interprets contracts and legal documents
- Mentors and assists less experienced Regulatory Compliance personnel
Education and/or Experience
For consideration, candidates will need to have a Bachelor's degree in a related field with at least five (5) to seven (7) plus years of related experience working in PBM, healthcare, or managed care and two (2) plus years of consistent HIPAA compliance expertise, or an equivalent combination of education and job-related experience. Candidates must demonstrate strong policy and procedure document writing expertise. Prior experience working in a regulatory compliance department is preferred.
To perform this job successfully, an individual must have MS Office Suite and Outlook experience and solid working knowledge of current HIPAA/HITECH requirements and related company training initiatives
Other Skills and Abilities
Strong listening skills and ability to convey regulatory compliance information, verbally and in writing, in an easy to understand format
Certificates, Licenses, Registrations
HIPAA Compliance Certification is preferred but not required.
This position is eligible for Employee Referral Bonus at Level II