MedImpact Healthcare Systems, Inc.

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Federal Programs Compliance Manager

at MedImpact Healthcare Systems, Inc.

Posted: 12/12/2019
Job Reference #: 5943

Job Description

Location:
San Diego, CA
 
Remote Location:


# of openings:
6
 
Department:


Employment duration:
Full time
 
Exemption Status:
Exempt

Relocation Assistance:
N/A
 
Added to system:
12/14/18 2:46 PM

Job Code:
560.181214.5943/HPP
 
 

Federal Programs 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.

Position Summary

The Federal Programs Compliance Manager is a subject matter expert that supports the enterprise and its’ clients with regard to federal and state programs including but not limited to: Medicaid, Medicare Part D and Health Insurance Exchanges (HIX) programs. This role provides proactive compliance monitoring and assessments with regard to key initiatives and increasing compliance requirements; advises internal business partners on changing laws and regulations.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

  • Monitors Health Care Reform Regulations, Medicaid and Medicare Part D Regulations, sub-regulatory guidance, and any other applicable communications distributed by regulatory bodies
  • Analyzes information for dissemination to appropriate internal operational areas, prepares overviews and other documentation to serve as compliance guidance in relation to implementation of specified requirements
  • Facilities meetings and manages committees/work groups to disseminate federal program compliance information
  • Collaborates with internal operational areas on compliance matters impacting MedImpact’s initiatives
  • Works in partnership with the Contracts Department to assist in the creation and modification of client contracts, pharmacy network contracts, vendor contracts, and regulatory addendums for federal programs, as needed
  • Assists with client contractual issues/concerns and with audits conducted on MedImpact’s services related to federal programs as well as corrective action plans (CAPs) related to compliance matters.
  • Develops and reviews organization’s policies and procedures in relation to federal programs

Education and/or Experience

For consideration, candidates will need a Bachelor’s degree in a related field (or equivalent combination of education and experience); Five (5) to eight (8) plus years’ job related experience including healthcare or managed care regulatory compliance experience, preferably in a PBM environment.  Prior experience with Medicaid or Medicare is required.   

Computer Skills

  • Strong PC skills in Microsoft Office Suite, MS Outlook
  • Other Skills and Abilities
  • Ability to research, assess, audit, and apply information to practices and standards

Travel

This position may require occasional domestic travel and attendance at various conferences and meetings

EOE, M/F/D/V

OSHA/ADA:

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.

Disclaimer:

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.