Regulatory Compliance Analyst

Under the direction of the Director of Regulatory Compliance, the Regulatory Compliance Analyst is responsible for ensuring the Benecard Companies meet and maintain ongoing compliance with all applicable Medicare, Medicaid and other federal and state regulatory requirements. The Regulatory Compliance Analyst is responsible for the research, assessment, monitoring and oversight of all compliance and regulatory requirements.

Responsibilities:

• Research, assess applicability of, and analyze compliance and legal matters as assigned.
• Assist with ensuring compliance with federal and state regulations for the practice of opticians and optometry, pharmacy and pharmacy benefit managers.
• Interpret and disseminate information on regulatory matters. Responsible for communicating CMS and/or other rules and regulations to responsible parties.
• Monitor and confirm compliance with federal, state, and local laws.
• Develop, review and modify compliance information in manuals, forms and/or contracts, as needed.
• Support a comprehensive Fraud, Waste and Abuse program that adheres to federal or state requirements.
• Accept requests from internal customers, understand the underlying issues, review regulatory rules, determine applicability, conduct analysis of risks and make recommendations relative to compliance with regulatory requirements.
• Assist development and/or annually review compliance policies and procedures to ensure consistency with governing statutes, regulations and other guidance. Review and update policies as laws and regulations change.
• Provide written and oral advice and guidance regarding compliance requirements that impact the company’s products and business as needed. Act as an internal resource on matters related to vision and pharmacy rules.
• Support overall enterprise-wide compliance and risk management strategy.
• Maintain a comprehensive understanding of all new and existing regulatory requirements that impact vision and pharmacy operations.
• Identify regulatory metrics to track compliance with regulatory requirements.
• Identify areas of potential compliance risk and collaborate with internal staff to develop solutions for risk mitigation.
• Assist in the development of a variety of training tools and communication vehicles to reinforce compliance enterprise-wide.
• Manage projects as assigned, including regulatory and compliance initiatives.
• Assist in compiling compliance information for presentation to the Compliance Committee, Board Compliance Committee or the Board of Directors, as necessary.
• Develop and manage compliance databases; prepare reports as required.
• Perform other duties, as assigned.

Education and/or Experience:

• AS, BA or BS degree
• Minimum of 3 years’ experience in compliance or legal fields
• Prior experience with vision, pharmaceutical, healthcare or managed care regulations
• Experience in Healthcare Compliance, Quality Improvement, and Regulatory Compliance
• Other Skills and Abilities:
• Ethical conduct
• Positive Attitude
• Solid verbal and written communication skills
• Good interpersonal and collaborative skills
• Critical thinking skills
• Strong Analytic skills
• Attention to detail
• Ability to manage timelines and balance multiple deadlines
• Ability to 'project manage' deliverables across multiple departments and follow-up to ensure completion
• Ability to work independently
• Proficient in Microsoft Office Suite with a focus on Excel, PowerPoint, Word, Outlook, and Project. SharePoint skills a plus.
• High degree of professionalism
• Travel Requirements:
• Minimum travel required

About Benecard and our affiliated companies:

Benecard Services, LLC

Benecard Services, LLC has been administering carve-out, fixed rate insured prescription drug benefit programs since 1990. Benecard is a full service, in-house prescription benefit administrator that includes mail and specialty drug dispensing. We are a premiere nationwide Prescription Benefit Administrator headquartered in Lawrenceville, New Jersey.

Website: http://www.benecard.com

BeneCard PBF

BeneCard PBF provides self-funded prescription benefit program administration with a personalized approach through focused, clinical expertise. Our business model operates on a customized claim processing system offering unlimited capability and flexibility to respond to client needs in an evolving marketplace. Advanced clinical programs and advanced technology provide the framework to maximize the use of all data elements available. This allows BeneCard PBF to filter the information, focus on clinical opportunities and facilitate interaction between the physician, the pharmacist and the patient to effectively promote complete health care. Headquartered in Bonita Springs, Florida.

Website: http://benecardpbf.com

National Vision Administrators

For over 40 years, National Vision Administrators (NVA) has been meeting the vision benefit needs of public employer groups, Health & Welfare Funds, Associations and Coalitions. Providing millions of people throughout the United States with vision care programs that help them be smarter buyers of eye care and eyewear, NVA is particularly well suited to address today's health benefit challenges as it relates to eye care. We offer cost-effective, customized vision benefit programs that are clinically integrated. We are proud of the fact that we have retained over 99% of our clients and believe it is the greatest testimony to the high-quality benefits and service satisfaction we provide to both our clients and their members. Headquartered in Clifton, New Jersey.

Website: http://www.e-nva.com

We are an equal opportunity employer