Remote Manager, Operational Regulatory

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make. Job Posting Title Remote Manager, Operational Regulatory & Industry Affairs **Job Description**: The Manager of Operational Regulatory and Industry Affairs is responsible for leading and managing the work effort, volume, analysis, implementation and productivity of regulatory, industry standards, and risk management efforts to ensure the department is operating in compliance with regulatory and/or contractual obligations. This position is responsible for the industry standards efforts for Prime as a whole, which includes influencing Standards Development Organizations and regulators to ensure the industry standards for Prime’s business environment and system needs are met. This position is also the primary point of contact responsible for leading the review, impact assessment, and drafting of comments for proposed regulatory and legislative items that impact operations. **Responsibilities**: - Oversee and manage a portfolio of legislative, regulatory, and industry standard items; ensure department leadership and Subject Matter Experts (SMEs) have a solid understanding of scope, deliverables, and deadlines associated with actionable items - Collaborate with impacted operational stakeholders to draft position statements and/or comments for proposed Federal and State regulatory or legislative items - Lead risk management activities for assigned department; develop and execute risk assessments, SOC1 control oversight, internal audit coordination, and targeted audit development - Participate and vote as a member of the National Council of Prescription Drug Benefits (NCPDP); establish and maintain engaged relationships with leadership and SMEs in other functional areas to ensure alignment with voting activities and that Prime’s interests are well represented at NCPDP workgroups - Collaborate with Prime departments and Senior Management on strategic initiatives to ensure the claim processing system supports and complies with relevant standards; facilitate gathering requirements, scope, governance, and system testing of industry standards related enhancements - Develop, manage and mentor staff; provide work direction and assign staff to regulatory, risk management, and industry standards projects to ensure goals and performance expectations are met - Other duties as assigned Minimum Qualifications - Bachelor’s degree in Business, Political Science, Pharmacy, Healthcare Administration or related area of study, or equivalent combination of education and/or relevant work experience. - 6 years of work experience in regulatory or compliance to include 3 years of pharmacy operations experience - 1 year of leadership/people management experience - Must be eligible to work in the United States without need for work visa or residency sponsorship Additional Qualifications - Strong critical thinking and analysis skills with the ability to solve complex problems and/or identify process improvements - Excellent verbal and written communication skills and ability to translate regulations into operational requirements - General understanding of the political process with strong influencing skills to persuade internal/external stakeholders - Strong attention to detail and the ability to manage multiple, complex projects without compromising quality Preferred Qualifications - Experience in a healthcare organization regulatory department - Master’s Degree - Previous experience working with NCPDP Minimum Physical Job Requirements - Ability to travel up to 25% of the time - Constantly required to sit, use hands to handle or feel, talk and hear - Frequently required to reach with hands and arms - Occasionally required to stand, walk and stoop, kneel, and crouch - Occasionally required to lift and/or move up to 10 pounds - Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and - ability to adjust focus Reporting Structure - Reports to a Director in the PBM Operations department Potential pay for this position ranges from $91,100.00 - $145,300.00 based on location, experience and skills. - To review our Benefits, Incentives and Additional Compensation, visit our - Benefits Page - and click on the "Benefits at a glance" button for more detail.