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Senior Business Analyst, Pharmacy Compliance

at HMSA

Posted: 10/2/2019
Job Reference #: 5000520284706
Keywords: compliance

Job Description

Employment Type

Full-time

Exempt or Non-Exempt

Exempt

Job Summary

Serve as a subject matter expert regarding regulatory compliance for the Pharmacy Management Department. Providing oversight and guidance to various operations, projects, and initiatives that are Pharmacy driven to ensure that appropriate Federal, State, and other regulatory body guidelines (NCQA, etc.) are being followed/met. Positon is responsible for planning, researching, analyzing, managing, and effectively communicating necessary regulatory changes that impact HMSA's business units. In addition the Senior Analyst is also responsible for reviewing, developing, modifying, and implementing process improvements that support the overall compliance performance of the Pharmacy department.

Minimum Qualifications

  1. Bachelor's degree and four years of related experience in pharmaceutical or healthcare regulations or other highly government regulated industry; or equivalent combination of education and related work experience.
  2. Basic knowledge of Microsoft Office applications. Including but not limited to Word, Excel, and Outlook. Basic knowledge and understanding of data management/database software.
  3. Knowledge/skills in project management
  4. Excellent communication skills (written and verbal)
  5. Proficiency in issues identification, resolution, and program operations
  6. Strong organization and time management skills to work on multiple projects simultaneously and meet project deadlines
  7. Strong interpersonal skills
  8. Effectively work independently and collaboratively

Duties and Responsibilities

  1. Project Management and Implementation:  Project manages a variety of compliance related programs/projects supporting HMSA's Pharmacy Operations Department. Will facilitate planning, execution, and evaluation of ongoing compliance efforts and monitoring activities. Assesses and audits current processes and controls to find efficiencies and improve standards. Responsible for recommending and implementing corrective actions based on audit findings. Actively informs internal and external stakeholders of workflow progress keeping all parties informed of next steps. Will function as a "business owner" of projects/programs by owning deliverables and ensuring timelines are met.
  2. Program Design, Research and Analysis:  Research and analyze various applicable compliance data, issues, and topics. Using analyses to design strategies, process frameworks, create reports, identify issues, and execute solutions. Continuously evaluate the measures, metrics, values, and standards that the department reviews and audits against. Properly identifying key stakeholders and effectively communicating any compliance updates, findings, and corrective measures.
  3. Cross-Functional Integration and Communication:  Function as a liaison for compliance throughout the organization for Pharmacy related issues. Responsible for creating and maintaining compliance training documents and guides ensuring accuracy and effectiveness. Oversees the distribution of information and materials to various HMSA departments as well as external parties. Will have to present compliance topics to a variety of audiences ranging from staff to senior management.
  4. Managerial support:  Conducts the tracking of vendor performance and evaluations/performance appraisals.Functions as a team lead over the other team members within the Pharmacy Operations department. Guiding and mentoring analysts to improve performance and methodologies. Will provide regular educational updates to the department regarding and updates and changes to Pharmacy regulations.
  5. Other Duties/Functions:  Performs all other miscellaneous responsibilities and duties as assigned or directed.