Department

Job Title

Capital Rx is redefining the way prescriptions are priced and administered in the U.S. Capital Rx unlocks the pharmacy supply chain and reduces prescription costs for employer groups. By establishing a competitive marketplace for drug pricing, Capital Rx focuses its resources on deploying actionable strategies that improve plan performance and patient outcomes. The company's commitment to innovation, technology, and service is why Capital Rx is the fastest-growing pharmacy benefit manager in America.

Compliance

Corporate Compliance Manager

Location: Remote (For Non-Local) or Hybrid (Local to NYC area)

About Capital Rx

Capital Rx is a next generation pharmacy benefits manager, overseeing prescription benefit plans on behalf of employers, unions, and government entities. Determined to transform an outdated model, Capital Rx’s mission is to change the way prescription benefits are priced and administered in the US, unlocking enduring social change. Through our platform approach, Capital Rx delivers data-driven insights and actionable strategies that reduce costs, while improving patient outcomes. Our commitment to innovation, technology and service is the reason why Capital Rx is among the fastest-growing PBMs in the country.

Position Responsibilities:

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• High integrity, professional, and able to effectuate change in a fast-growing organization to assist the VP of Corporate Compliance in the development, execution, oversight, and advancement of Capital Rx’s Corporate Compliance Program
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• Understanding of the Office of Inspector General’s (OIG) Seven Fundamental Elements of an Effective Compliance Program and translate those requirements into a comprehensive compliance program/work plan
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• Assist in development and implementation of internal risk assessments and audit plans to ensure compliance with applicable laws and regulatory requirements and be able to measure the effectiveness of the Corporate Compliance Program
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• Develop an annual compliance communication work plan and other materials to promote compliance with Capital Rx’s Code of Conduct
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• Vendor Management compliance including monitoring and auditing of First Tier, Downstream and Related Entities (FDRs)
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• Investigate, analyze, respond, and trend all compliance hotline calls received
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• Monitor and report updates to leadership on the Corporate Compliance Program’s key performance indicators, goals, and strategies
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• Serve as a subject-matter expert on compliance topics and maintain a comprehensive knowledge of applicable laws, regulations, and policies by partnering with the legal department in order to be able to audit and monitor any regulations that may impact the Company
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• Support operational business areas in ensuring compliance with applicable laws, regulations, and policies, and other items of general compliance
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• Support RFP and RFI responses and meet with stakeholders to discuss compliance topics, if necessary
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• Assist in the development and maintenance of a risk-based compliance training curriculum
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• Responsible for oversight and collaboration with key stakeholders to ensure compliance onboarding, annual, and any other required compliance-related trainings are completed per company policy and regulatory requirements
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• Investigate compliance-related issues and collaborate with departmental stakeholders to develop formal corrective actions plans for compliance-related issues when required
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• Prepare and report activities to the VP of Corporate Compliance and to the Corporate Compliance Committee
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• Partner with business areas to assist in the creation, maintenance, and/or improve effective, accurate, and efficient departmental policies
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• Maintain current knowledge of lines of business to support compliance of ongoing business operations
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• Work closely with the executive team and other key leadership stakeholders
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• Build and maintain trusting relationships with internal and external stakeholders through service delivery excellence and oversight
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• Other compliance duties as assigned by the VP of Corporate Compliance
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Required Qualifications:

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• 5+ years of PBM and/or health plan compliance experience
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• Demonstrated track record of leveraging a deep understanding of audit requirements and industry standards
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• Experience with complex regulatory audits including. CMS Program Audits are a plus
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• Strong verbal and written communication experience including executive, regulatory, and client presentations, and complex compliance and legal communications
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• Track record of leading and managing complex, cross-functional initiatives, and projects, driving high performance, meeting deadlines, and executing on deliverables
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• Extremely flexible, highly organized, innovative, with ability to shift priorities easily
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• Attention to detail & commitment to delivering high quality work product
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Education/Certification Requirements:

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• Bachelor’s degree in business, healthcare, or related field
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• Extensive work experience may be considered in lieu of degree(s)
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• Healthcare Compliance Certification (CHC) preferred
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Base Salary: $100,000 - $115,000

This range represents the low and high end of the anticipated base salary range for the NY - based position. The actual base salary will depend on several factors such as: experience, knowledge, and skills, and if the location of the job changes.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.