[Remote] Pharmacy Regulatory Compliance Analyst

Note: The job is a remote job and is open to candidates in USA. ALTA IT Services is staffing a 100% remote, contract-to-hire opening for a Pharmacy Regulatory Compliance Analyst to support a leading healthcare payer. This role involves conducting independent analysis for high-level regulatory inquiries and ensuring compliance with state and federal requirements specific to Pharmacy Benefit Management.

Responsibilities

• Monitor updates to federal and state regulations (e.g., CMS, URAC, state mandates) and ensure pharmacy content remains current.
• Review and approve all pharmacy-related communications for compliance, accuracy, and timeliness.
• Coordinate with legal, regulatory, and compliance teams to validate communication strategies and mitigate risks
• Maintain documentation and version control for all regulated pharmacy communications.
• Research, resolve and respond to written inquiries forwarded from Congressional, Attorney General and State officials, members, providers, groups and brokers.
• Coordinate with internal and external parties to ensure accurate information is obtained.
• Review and analyze provided data and information.
• Provide detailed professionally written responses to originating party, ensuring all questions are answered and customer needs are effectively served within designated timeframes while ensuring privacy needs of members are respected.
• Review, analyze, prepare detailed documentation for support of legal action pertaining to Corporate indemnity business, ensuring that all appropriate materials, related claims, contracts, payment vouchers are included.
• Develop a summary/assessment of included documentation for legal staff.
• Meet, discuss, and strategize with legal staff to prepare for depositions, court cases or administrative hearings.
• Appear as required to testify on behalf of Corporate.
• Review moderately complex business processes and systems to identify, document, elevate the presence of risks and trends within systems and processes that may be non-compliant with contracts and or statutory requirements especially in the claims processing, enrollment and service arenas – all jurisdictions, all products, all processing platforms to include our subsidiaries.
• Actively participate in implementation/corrective workgroups to ensure compliance perspective and concerns are addressed through the process.
• Provide research, investigative and analytic support on special projects ensuring that all Corporate policies and contractual guidelines are clearly identified.
• Provide support to supervisors and other internal associates with written responses to inquiries. Skills
• Bachelor's Degree
• 5 years of experience in a compliance or senior-level customer service role
• Deep understanding of CMS, URAC, state requirements, and other pharmacy compliance standards
• Reviewing and validating content to ensure clarity, consistency, and alignment with requirements
• Partnering with legal, regulatory, and other internal teams to review and maintain standards
• Identifying and addressing gaps in pharmacy communications
• High-quality, accurate writing and editing of regulated communications Benefits
• Benefits available
• W2 Benefits available
• Plus benefits Company Overview
• ALTA IT Services, LLC combines experience and expertise to deliver IT talent that meets and exceeds the expectations of our clients. It was founded in 2004, and is headquartered in Rockville, Maryland, USA, with a workforce of 201-500 employees. Its website is Apply tot his job Apply tot his job

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