Regulatory and Compliance Specialist - On-site or Remote

Company: ProAct Inc
Location: East Syracuse
Posted on: May 28, 2023

Job Description:

Overview
The Regulatory & Compliance Specialist works under supervision of the Director of Regulatory and Compliance to ensure compliance with -laws and regulations pertaining to pharmacy benefit managers (PBM) acting as either a pharmacy benefit manager or third-party administrator (TPA). By partnering with members of the regulatory and compliance team, along with other departments, ensures ProAct services are consistent with law, rules, regulations, and accreditation standards. The Regulatory & Compliance Specialist will research and interpret rules and regulations and coordinate with the Director of Regulatory and Compliance to determine potential impact. - This position will also be responsible for conducting and presenting audit findings, along with working with both internal and external legal resources as necessary.
Responsibilities

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• Identifies and explores regulatory developments affecting pharmacy benefit managers acting as a PBM or TPA.
  
• Research and interpret current, pending, and future rules and regulations and how may impact ProAct and/or clients and business partners.
  
• Tracks pertinent legislative and regulatory changes and communicates to others.
  
• Review regulatory publications from agencies and industry trade organizations.
  
• Partner with Director of Regulatory and Compliance to identify impactful legislation/regulations and communicate with others within the organization.
  
• Conduct audits of policies and/or procedures by examining records, reports, SOP, and other documentation to ensure compliance with state and federal laws.
  
• Support preparation of regulatory filings and responding to regulatory inquiries and examinations.
  
• Supports HIPAA compliance efforts to ensure policies and procedures are appropriate to meet requirements.
  
• Assist in development with employee compliance training and development programs within ProAct.
  
• Communicates with external agencies or partners as needed.
  
• Assist in reporting or other requirements as a condition of licensure, as needed.
  
• Assisting with preparation and reviewing of contracts and management of contract life cycle as needed.
  
• Provides support, when needed, to ProAct Pharmacy Services for regulatory and/or compliance matters.
  
• Partner with internal and external legal resources as needed relating to regulatory and/or compliance issues.
  
• Prioritizes workflow to meet internal and external deadlines.
  
• Maintain appropriate records and documentation relating to job duties.
  
• Assist in licensing and registration requirements when needed.
  
• Responsible for completing all mandatory and regulatory training programs
  
• Perform other duties as assigned
  
  
  Qualifications
  Education:
  
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  • BS in regulatory specialization, degree from an approved US paralegal training institution, or an equivalent combination of education and corporate or law firm experience.
    
    
    Experience: -
    
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    • 3+ years as paralegal or regulatory specialist
      
    • Previous role in a position requiring a team or collaborative working environment
      
      
      Job Skills Required:
      
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      • Strong Communication Skills: Must be able to effectively communicate both on the phone and in group setting
        
      • Strong Organizational Skills
        
      • Self-motivated with ability to prioritize multiple tasks along with a strong sense of urgency and responsiveness
        
      • Strong research capabilities with ability to use web-based resources and navigate state/federal/other statutes and regulations
        
      • Extensive familiarity with interpreting regulatory regulations and laws
        
      • Understanding of PBM and/or TPA industry, preferred
        

Keywords: ProAct Inc, Syracuse , Regulatory and Compliance Specialist - On-site or Remote, Other , East Syracuse, New York