Compliance Analyst, Risk, Audit, and Monitoring

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 risk detection, auditing, monitoring, and development of these elements. In this role, you will assist, build, and lead initiatives which detect 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. Arrangement:

• Remote, full time employee. General office environment; 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.
• Reports to the Compliance Director

What you will do: Primary Responsibilities:

• Design and/or enhance targeted and annual risk assessments
• Develop risk methodologies, scoring, and prioritization
• Construct specific and effective auditing and monitoring workplans based on risks identified
• Perform timely auditing and monitoring activities
• Analyze compliance outcomes and ensure detected issues are referred for remediation
• Identify ways to mitigate risks to our organization
• Coordinate external audits, as assigned
• Create and run mock audits
• Build and perform readiness testing exercises
• 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
• Perform root-cause analysis and identify prevention, detection, and correction opportunities
• Ensure business partners complete corrective actions in a timely and effective manner
• 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 will bring to SmithRx: 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 audit and monitoring activities, compliance risk assessments
• 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
• Paid Company Holidays
• Wellness Benefits
• Commuter Benefits
• Paid Parental Leave benefits
• Employee Assistance Program (EAP)
• Well-stocked kitchen in office locations
• Professional development and training opportunities

Apply tot his job Apply To this Job