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 Determined to transform an outdated model, Capital Rx’s mission is to change the way prescription benefits are priced and administered in the US, unlocking enduring social change.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:

• Create and maintain Internal Monitoring and Auditing program, including various targeted mock audits and review
• Coordinate internal and external audits 
• Conduct, maintain, and report ongoing risk assessment activities
• Investigate compliance issues including corrective action plan creation, oversight, and reporting
• Vendor Management compliance including monitoring and auditing of First Tier, Downstream and Related Entities (FDRs)
• Support operational business areas in ensuring compliance with applicable requirements including federal and state laws, regulations, guidance, orders, bulletins, and other items of general compliance
• Partner with business areas to create, maintain, and/or improve effective, accurate, and efficient business processes
• Maintain current knowledge to support compliance of ongoing business operations
• Work closely with the executive team and other key leadership stakeholders
• Develop internal and external compliance communications or other materials
• Build and maintain trusting relationships with internal and external stakeholders through service delivery excellence and oversight
• Other compliance duties as assigned by the Compliance Officer, including but not limited to, licensing support, process improvements and efficiencies, product creation and maturation

Required Qualifications:

• Bachelor’s degree in business, healthcare, or related field
• Extensive work experience may be considered in lieu of degree(s)
• 5+ years of PBM and/or health plan experience
• Must have the desire to work in a start-up environment where you get to build out processes and procedures 
• Demonstrated track record of leveraging understanding of audit requirements and industry standards
• Experience with complex regulatory audits including, but not limited to, CMS Program Audits
• Risk identification and communication including resolution communication, tracking, and trending
• Executive, regulatory, and client presentation and communication experience including complex compliance and legal communication
• Track record of leading and managing complex, cross-functional initiatives, and projects, driving high performance, meeting deadlines, and executing on deliverables
• Exceptional written and verbal communication skills
• Extremely flexible, highly organized, innovative, with ability to shift priorities easily
• Attention to detail & commitment to delivering high quality work product

Base Salary: $100,000 - $135,000

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.