Compliance Specialist

Independent Health Association•Buffalo, NY

11d•Hybrid

About The Position

The Compliance Specialist is responsible for executing, administering, and monitoring compliance programs related to contractual obligations and general and pharmacy regulatory requirements. The role supports contract and regulatory activities and serves as a liaison among Reliance Rx business units, the parent company Compliance Department, related departments, vendors, and regulatory bodies. The specialist conducts regulatory research and analysis concerning proposed, pending, and effective laws, rules, and regulations that affect Reliance Rx pharmacy operations. Working with the Reliance Rx Leadership Team, pharmacy team, business development, and internal audit, the specialist helps ensure leadership is informed and operations comply with applicable regulations and contract provisions. The position reports to the Deputy Counsel-Regulatory Compliance Manager and works under that manager’s direction. This is a hybrid position with onsite attendance required at the Williamsville location. Immigration or work visa sponsorship will not be provided. Hiring compensation is $30.00–$35.00 hourly; compensation may vary based on skills, education, location, and experience. In addition to base compensation, associates may be eligible for a scorecard incentive, a full range of benefits, and generous paid time off.

Requirements

Associate’s degree required; an additional two years of experience may be considered in lieu of a degree.
Three years of compliance, quality assurance/audit, or program/process management experience required.
Advanced computer and Windows skills required.
Experience with Microsoft Office applications and demonstrated ability to learn new software applications.
Excellent research skills and independent judgment to determine which regulatory changes should be presented in collateral and training.
Excellent analytical skills, including the ability to analyze legislation and draft and implement policies and procedures based on regulatory requirements.
Excellent composition and drafting skills, particularly for compliance and regulatory documents and correspondence.
Excellent verbal, written, and interpersonal communication skills.
Ability to build and maintain relationships with internal and external stakeholders.
Proficiency in conducting research and preparing substantive work requiring knowledge of compliance concepts, particularly HIPAA.
Initiative, creativity, project management, and organizational abilities.
Examples of demonstrating Reliance values: Collaborative, Accessible, Results-Oriented, Empowering, and Supportive.

Nice To Haves

Healthcare experience preferred.
Specialty pharmacy or pharmacy experience preferred.
Experience with payor and regulatory enrollment and maintenance preferred.

Responsibilities

Monitor and research federal and state laws, regulations, and guidance affecting pharmacy operations, specialty pharmacy, distribution, 340B, Medicare, Medicaid, HIPAA, and other applicable requirements.
Track regulatory changes and coordinate with operational leaders, pharmacists, and stakeholders to communicate and implement new and existing requirements.
Maintain knowledge of compliance obligations and provide recommendations, guidance, and updates to leadership.
Develop and maintain processes to monitor compliance with contractual obligations and regulatory requirements.
Collaborate with Compliance, Finance, Business Development, and other stakeholders during contract review, negotiation, implementation, and administration.
Facilitate contract processing, document management, compliance obligation tracking, approvals, revisions, signatures, and records retention.
Research requirements supporting Medicare and Medicaid enrollment acquisition and maintenance in all states and U.S. territories.
Support accurate and timely resident and non-resident pharmacy state licensing renewals.
Support timely completion and renewal of state PDMP waivers or alternative zero reporting.
Coordinate updates to licensing and credentialing entities regarding corporate information, pharmacy staff or other personnel, hours, and related changes.
Maintain tracking mechanisms for licensing and credentialing.
Ensure timely renewal and ad hoc updates to the business NCPDP profile.
Complete and facilitate documentation and applications for timely initial and renewal payor credentialing submissions.
Develop and maintain tracking and monitoring processes for business operations, applications, and renewals, coordinating with other departments.
Support development, implementation, and communication of compliance, privacy, and security programs with parent Compliance and Information Risk teams.
Manage compliance policies and procedures, including drafting, review, updates, regulatory citation validation, and document organization.
Develop and maintain compliance metrics, dashboards, tracking tools, and process improvements.
Coordinate compliance training, onboarding, annual education, attestations, assessments, and awareness activities.
Serve as a liaison between business units and parent Compliance, facilitating committee activities, issue escalation, investigations, corrective action plans, and regulatory inquiries.
Support privacy and security monitoring, incident reporting, remediation, audits, and government investigations as required.
Act as the primary contact for associate compliance, privacy, security, and conflict-of-interest inquiries and concerns.
Collaborate with operational teams, data management, and internal audit on compliance-related system access, controls, and oversight.