Maxor National Pharmacy Services Company is currently seeking a TPA and Regulatory Compliance Officer for its Pharmacy Benefit Management and Third Party Administrator entities in downtown Amarillo. The TPA and Regulatory Compliance Officer is responsible for keeping Maxor in compliance and provides support to the senior management team with compliance and regulatory matters relating to the operations of the company and those of the clients.
Primary duties and responsibilities:
- Monitors regulatory affairs and compliance requirements specific to the TPA and PBM industries and their clients for applicable issues; assisting with TPA licensing and state reporting where applicable.
- This position will be involved in providing information that could significantly impact clients and Maxor through their research and analysis of data/information; and interpreting federal and state laws, including DOL, CMS regulations, ERISA, and ACA
- Track, analyze, and interpret proposed regulations/rulemaking/bulletins as it impacts the businesses and advises key members of management, the Compliance Officer, and the Compliance committee on these various pending issues
- Act as a knowledgeable resource on operational compliance matters related to the organizations’ activities, including audit & examination support as well as, consistency of services performance with client contracts and applicable laws.
- Provide knowledgeable partner support to insurer clients with respect to laws applicable to such insurers such that compliance is viewed as a reason to do business with Maxor
- Advise leadership on Federal and State restrictions and limitations in law and contract applicable to clients and insurers
- Serve as a knowledgeable resource for management regarding managed care and PBM insurance arrangements
- Assist in the preparation and negotiation of client administrative services agreements, vendor and supplier contracts, and sub-contracts, and other business.
- Document and prepare reports on regulatory and compliance matters as needed
- Assist with SOC/SSAE16 readiness/compliance, audit standards.
- Bachelor’s Degree required
- Superior verbal and written communication skills
- Demonstrated understanding of the pharmacy business and/or the managed care industry
- Health Care Administration, Business Administration, Auditing, or in a field related to health care compliance preferred
- Background as a Paralegal or Law Degree highly desired
- Minimum of 5+ years of experience in a health care organization, TPA and/or pharmacy compliance experience preferred
- Proficient in the use of computers and various software programs
About Maxor National Pharmacy Services Company
Maxor provides patients and corporate clients across the country with pharmacy and healthcare services that are customizable, comprehensive and cost-effective. Founded in 1926, Maxor has grown from a single pharmacy in Amarillo, Texas, into a national leader in a number of areas, including retail and mail order pharmacies, pharmacy benefit management, pharmacy consulting and management, home infusion, specialty pharmacy, third-party administration services, correctional pharmacy services, pharmacy audit, and pharmacy technology.
Maxor offers a culture that promotes teamwork and where employees are valued as the Company’s best asset. We work hard, but we make sure to have fun along the way, too. Competitive salary, plus a great benefits package are available.
For consideration, please download and complete an employment application atwww.maxor.com.employment.shtml or submit a confidential resume to email@example.com. For questions, please call Human Resources at 800-658-6146 ext 5426.