Compliance Counsel Counsel Jobs in Missouri - 142020 | Submit Resume | General Counsel Consulting
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Melinda Burrows
Deputy General Counsel
- Litigation and
Compliance, Progress
Energy Service Company
LLC
 

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Compliance Counsel
Refer job# POKW142020
 
Compliance Legal Analyst The candidate provide attorney support for the compliance program. Provide oral and written interpretation, analysis, and opinions regarding statutes, regulations, binding sub-regulatory guidance, accreditation standards, policies and procedures, contracts, and business associate agreements. Lead special projects. Write/revise policies and procedures. Develop and implement monitoring/auditing strategies and compliance reports. Perform legal research, including 50-state surveys, regarding the propriety of current or proposed courses of action. Review business materials for compliance with relevant statutes, regulations, binding sub-regulatory guidance, accreditation standards, policies and procedures, and contracts. Review and synthesize legal and regulatory requirements and create policy or position statements. Investigate potential compliance violations. Interview complainant, witnesses, and others as necessary. Investigate external complaints and prepare written response to allegations. Perform research related to the companys PBM, TPA, utilization management, pharmacy, wholesale distributor, DMEPOS and DME-related licenses and agreements. Provide attorney support for the regulatory bulletins program. Perform research related to recently enacted statutes and regulations. Assist in understanding the applicability of the new law or rule to the companys business. Provide development guidance and assist in the identification, implementation, and maintenance of compliance policies, procedures, and training/monitoring programs. Serve as a resource and liaison regarding policies, contract issues and provisions, communications, workflow, and quality improvement initiatives. Respond to external requests for information required by the organization for its regulatory filings. Manage compliance reporting responsibilities and respond to inquiries from state and federal regulatory agencies. Manage ethics and compliance projects or implementations. Review and synthesize regulatory requirements and create policy and/or position statements. Communicate state and federal requirements to internal and external clients. Provide development guidance and assist in the identification, implementation, and maintenance of compliance policies, procedures and work instructions. Assist in the identification, analysis, and resolution of compliance issues. Maintain and review regulatory documentation necessary to maintain corporate standards. Assist in developing, producing and conducting compliance training programs. Perform periodic compliance audits, risk assessments and conducts related to ongoing compliance monitoring activities. Assist in managing relationships with regulatory agencies and seek to resolve policy issues which may negatively impact service to members. Serve as a resource and liaison on policies, contract issues and provisions, communications, workflow, and quality improvements initiatives. Assist business unit with understanding and implementing compliance with regulatory standards. Perform investigations of alleged compliance violations and prepare investigation reports.

A Bachelors degree required, preferably in a health-related field. Juris Doctor degree required. Should have 3+ years of experience practicing law in the area of health law at: (1) a private law firm; (2) the legal or compliance department of a health care company, e.g., pharmacy, pharmacy benefit manager, third party administrator, drug manufacturer, drug distributor, health plan, etc.; (3) a state or federal regulatory agency focused on healthcare, e.g., state Medicaid agency, state board of pharmacy, Food and Drug Administration, U.S. Department of Health and Human Services, etc.; or a combination of experience practicing law in the above three categories. License/Certification: Licensed to actively practice law in the state where the legal and compliance work will be performed. Alternatively, an in-house registration (or license) to practice law in that state is acceptable. Legal or compliance experience related to the Medicare Part D Program is preferred.
 
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