Senior Compliance Analyst – Medicare/Medicaid

Prime Therapeutics

. Execute compliance procedures and enforce policy governance to validate regulatory reporting and operational requirements .

Posted 10/23/2026full-timeRemote • United StatesSenior💰 $74,000 - $118,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in compliance program principles and practices, with a strong focus on regulatory reporting, policy governance, and stakeholder engagement. Proven ability to manage complex compliance initiatives and effectively communicate with senior leadership.

Highest-signal resume keywords

Compliance Program ManagementRegulatory ReportingStakeholder EngagementProject ManagementCritical Thinking

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Regulatory CompliancePolicy GovernanceDocumentation EnhancementLicensing ManagementMedicare ExperienceMedicaid ExperienceAffordable Care Act ExperienceCompliance TrainingConflict of Interest ManagementAnalytical Skills

Soft Skills

Exceptional Communication SkillsProblem-Solving SkillsOrganizational SkillsInfluencing SkillsCritical Thinking

Certifications & Qualifications

Certified Compliance and Ethics Professional (CCEP)Certified in Healthcare Compliance (CHC)Project Management Professional (PMP)

Industry Keywords

Healthcare CompliancePBM ExperienceLegal ComplianceRegulated IndustryCompliance Documentation

Tech Stack

Tools & technologies

PMP

About the role

Key responsibilities & impact

Execute compliance procedures and enforce policy governance to validate regulatory reporting and operational requirements
Serve as a compliance subject matter expert and develop solutions to highly complex issues
Enhance supporting documentation
Represent Compliance on complex contracts and cross-functional projects
Establish effective stakeholder partnerships
Lead project management for highly sensitive or complex compliance initiatives
Prepare clear and accurate compliance records and executive or governance reporting for senior leaders and committees
Execute and enhance compliance programs, training, conflict of interest, policy governance, and cyclical compliance processes
Research and interpret laws, guidance, regulatory issues, and filing requirements
Document and escalate findings
Manage assigned licensing submissions, filings, renewals, reporting, source documentation, procedures, and tools
Perform other duties as assigned
Comply with job-specific security responsibilities, legal, regulatory, contractual, and internal policy requirements

Requirements

What you’ll need

Bachelor’s degree in business, healthcare, or related area of study, or equivalent combination of education and/or relevant work experience
High school diploma from an accredited school or equivalent GED required
5 years of progressive work experience in legal or compliance-related roles for a healthcare or PBM organization, or another highly regulated industry
Experience with Medicare, Medicaid, and the Affordable Care Act (ACA)
Must be eligible to work in the United States without work visa or residency sponsorship
Exceptional written and verbal communication skills
Critical thinking and problem-solving skills for highly complex situations
Comprehensive understanding of compliance program principles, practices, standards, industry challenges, and emerging approaches
Ability to present complex information and influence stakeholders at all organizational levels
Advanced organization and analytical skills; ability to manage multiple projects simultaneously
Preferred: PBM or healthcare experience
Preferred: Certified Compliance and Ethics Professional (CCEP) or Certified in Healthcare Compliance (CHC)
Preferred: Project Management Professional (PMP)
Preferred: Medicare Part D, Medicaid, and/or Affordable Care Act experience
Preferred: Advanced degree in a related area of study, such as Juris Doctor
Preferred: Licensing application maintenance, tracking, renewal, and submission experience

Benefits

Comp & perks

Benefits, incentives, and additional compensation (details provided via the employer’s Benefits Page)
Equal opportunity and affirmative action employer
Reasonable accommodations for employees with disabilities
Tobacco-free workplace