Job Summary
A managed care organization has a current position open for a Remote Compliance Specialist.
Individual must be able to fulfill the following responsibilities:
- Write client bulletins, policies, desktop procedures, and corrective action plan responses
- Support the investigations of reported issues of suspected non-compliance or fraud, waste and abuse
- Participate in the review and revision of various areas of program training as needed
Must meet the following requirements for consideration:
- Minimum three years of experience with a Pharmacy Benefit Manager (PBM) in compliance related area
- Bachelor's Degree or a minimum of four (4) years of relevant experience required
- Minimum two years of professional work experience in regulatory compliance, internal audit, and/or investigation required
- Professional work experience at a Medicaid MCO/Medicare health plan
- Strong PC skills, including experience with MS Project, MS Office, MS Outlook or equivalent
- Ability to exercise professional judgment in analyzing and resolving issues
