Aspen Regulatory Internal Project Manager at Medimpact

Exemption Status:

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Summary:

The Aspen RxHealth Internal Regulatory Project Manager is responsible for internally coordinating appropriate regulatory processes for Aspen Health Rx in coordination with Corporate policies and procedures, including compliance, privacy and internal procurement activities.  The role will have a strong emphasis on collaborative efforts that have a focus on data privacy, government programs, and third-party vendor risk management. This role ensures that Aspen RxHealth meets all regulatory, contractual, and other required obligations while safeguarding sensitive data and managing risks associated with external partnerships. The role will collaborate with MedImpact’s compliance team on a regular and on-going basis to ensure Aspen RxHealth operates in a compliant manner while meeting business objectives. While coordinating with leadership and MedImpact’s Privacy Officer and Corporate Compliance Officer, will implement additional compliance policies and procedures as needed and required for the MTM business, navigate client regulatory requirements including those found in government derived programs, conduct risk assessments, identify potential risks, perform audits and provide input for Corporate Compliance training to promote a culture of compliance.

Essential Duties and Responsibilities:

• Works with MedImpact Corporate Compliance Officer and Privacy Officer to develop, implement, and administer the Aspen RxHealth medication therapy management (MTM) Compliance Program, ensuring adherence to laws, regulations, and internal policies (e.g., HIPAA, GDPR, SOX, CCPA, etc.).
• Serves as a member of the Corporate Compliance Committee and is accountable for the activities and status of the Aspen RxHealth Programs, including providing input to established trainings and policies and participating in investigating issues of non-compliance.
• Conducts regular risk assessments and compliance audits; prepares and presents reports to Corporate Compliance Committee and others on an as needed basis.
• Connects activities under a common compliance framework, to consolidate compliance-related data and provides management with better monitoring tools and information for decision-making.
• Leads investigations into Aspen RxHealth compliance issues and implements corrective action plans.
• Monitors and interprets new legislation and regulatory trends considering changes in the organization's needs, and in the statutes, rules, regulations, and requirements of Federal and State health care programs.
• Participates in the day-to-day functions of the Aspen Rx Health compliance and privacy program.
• Continuously monitors the overall effectiveness of the Aspen RxHealth Compliance Program and related activities; identifying gaps, implementing remediation plans; working cooperatively with the MedImpact compliance team.
• Conducts privacy impact assessments (PIAs) and oversees incident response for data breaches and privacy complaints for Aspen RxHealth; coordinates with Corporate Compliance on any actions that need to be taken.
• Coordinates with Corporate Procurement Programs to manage the vendor risk profile in accordance with the MedImpact vendor management team including due diligence, contracting, monitoring, and remediation processes.
• Collaborates with procurement, Chief Information Security Officer, vendor management, legal, IT security, and business units to assess vendor compliance with privacy, security, and operational standards.
• Ensures data sharing agreements and vendor contracts meet regulatory and organizational requirements.
• Acts as a liaison between Medimpact compliance staff, Aspen RxHealth departments, regulatory agencies, and external auditors.

QUALIFICATIONS:

Education and/or Experience –

BS/BA and 5+ years’ experience or equivalent combination of education and experience, and 2 years' of SME in respective areas

Certifications:

Certified in Healthcare Compliance (CHC) preferred or agreement to obtain within first year of employment.  In lieu of the CHC certification, either of the following are preferred: Healthcare Privacy Compliance (CHPC) or Certified Compliance and Ethics Professional (CCEP). 

Experience:

• 5+ years of progressive experience in compliance, privacy, or legal roles.
• Deep understanding of relevant privacy and compliance regulations (HIPAA, GDPR, CCPA, etc.).
• Experience managing third-party risk or vendor governance program
• Expert in the seven elements of compliance as defined by the Office of Inspector General’s (OIG) compliance guidance and Centers for Medicare and Medicaid’s (CMS) compliance program guidelines.

Computer Skills:

Strong PC skills in Microsoft Office Suite, MS Outlook

Other Skills and Abilities:

• Ability to research, assess, audit, and apply information to practices and standards.
• Solid CMS knowledge and expertise.

Reasoning Ability:   

• Ability to define problems, collect data, establish facts, and draw valid conclusions.

• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.

Mathematical Skills:

• Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.

• Ability to add and subtract two digit numbers and to multiply and divide with 10's and 100's.  Ability to perform these operations using units of American money and weight measurement, volume, and distance.

Language Skills:    

• Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.

• Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. 

• Competencies To perform the job successfully, an individual should demonstrate the following competencies:

Composure

Decision Quality

Organizational Agility

Problem Solving

Customer Focus

Drive for Results

Peer Relations

Time Management

Dealing with Ambiguity

Learning on the Fly

Political Savvy

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic).

Work Location

This position works on-site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders.

Travel:

This position may require travel up to 5% of the time.

The Perks:

• Medical / Dental / Vision / Wellness Programs
• Paid Time Off / Company Paid Holidays
• Incentive Compensation
• 401K with Company match
• Life and Disability Insurance
• Tuition Reimbursement
• Employee Referral Bonus

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego,
California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/Veterans

OSHA/ADA:

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above
statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.