Compliance Specialist

Responsibilities

Monitor and research federal and state laws, regulations, and guidance related to pharmacy operations, specialty pharmacy, distribution, 340B, Medicare, Medicaid, HIPAA, and other applicable regulatory requirements

Track regulatory changes and coordinate with operational leaders, pharmacists, and other stakeholders to communicate, implement, and maintain compliance with new and existing requirements

Maintain subject matter knowledge of compliance obligations and provide recommendations, guidance, and updates to leadership as needed

Develop and maintain processes to monitor compliance with contractual obligations and regulatory requirements

Collaborate with Compliance, Finance, Business Development, and other stakeholders during contract review, negotiation, implementation, and ongoing administration

Facilitate contract processing, document management, compliance obligation tracking, and required approvals, revisions, signatures, and record retention

Research regulatory requirements for Reliance Rx to support acquisition and maintenance of Medicare and Medicaid enrollment(s) in all states and US territories

Support resident and non-resident pharmacy state licensing renewals processing accurately and in a timely manner

Support timely completion and renewal of state PDMP waivers or alternative zero reporting

Coordinate internal resources and complete required updates to licensing and credentialing entities regarding changes in corporate information, changes to pharmacy staff or other relevant personnel, changes in hours, and related updates

Support maintenance of tracking mechanisms regarding licensing and credentialing

Ensure timely renewal and ad hoc updates to the business NCPDP profile are completed

Complete and facilitate all necessary application and documentation requirements for the timely submission of initial and renewal payor credentialing

Develop and maintain tracking and monitoring processes to ensure compliance with business operations, application and renewal requirements, including coordination with other departments

Support the development, implementation, and communication of the organization's compliance, privacy, and security programs in coordination with parent Compliance and Information Risk teams

Manage compliance policies and procedures, including drafting, review, updates, regulatory citation validation, and organization of related documentation

Develop and maintain compliance metrics, dashboards, tracking tools, and process improvements to support program effectiveness and regulatory oversight

Coordinate compliance training, onboarding, annual education, attestations, assessments, and awareness activities for associates

Serve as a liaison between business units and parent Compliance, facilitating committee activities, issue escalation, investigations, corrective action plans, and regulatory inquiries

Support privacy and security monitoring, incident reporting, remediation efforts, audits, and government investigations as required

Act as the primary point of contact for associate compliance, privacy, security, and conflict-of-interest inquiries and concerns

Collaborate with operational teams, data management, and internal audit to support compliance-related system access, controls, and oversight

Preferred

Healthcare experience preferred

Experience with specialty pharmacy/pharmacy preferred

Experience with payor and regulatory enrollment and maintenance preferred

Benefits

Associates may be eligible for a scorecard incentive.

Generous paid time off.

Hybrid position with onsite attendance required at the Williamsville location.

Health insurance plans and HMO services in Western New York.

Buffalo, New York, USA

https://www.independenthealth.com

Late Stage

Total Funding

unknown

2025-11-18

Acquired

Leadership Team

Michael W. Cropp, M.D., M.B.A.

President and CEO

Jim Dunlop Jr.

Executive Vice President and Chief Financial Officer

Recent News

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Qualifications

Associate's degree required

An additional two (2) years of experience will be considered in lieu of degree

Three (3) years of compliance, quality assurance/audit or program/process management experience required

Advanced computer and Windows skills required

Experience with Microsoft Office applications and demonstrated ability to learn new software applications

Excellent research skills and ability to exercise independent judgement to determine which changes in regulatory landscape should be presented in collateral and training

Excellent analytical skills, ability to analyze components of legislation and implement and draft necessary policies and procedures based upon regulatory requirements

Excellent composition and drafting skills, with emphasis on various compliance/regulatory documents and correspondence

Excellent communication skills, both verbal and written, and excellent interpersonal skills

Ability to effectively build and maintain relationships with both internal and external stakeholders

Proficiency in performing necessary research and preparing substantive work which requires knowledge of compliance concepts, with emphasis on HIPAA

Possess initiative, creativity, project management and organizational abilities

Proven examples of displaying the Reliance values: Collaborative, Accessible, Results-Oriented, Empowering, Supportive

Immigration or work visa sponsorship will not be provided for this position

Healthcare experience preferred

Experience with specialty pharmacy/pharmacy preferred

Experience with payor and regulatory enrollment and maintenance preferred

An additional two (2) years of experience will be considered in lieu of degree.

Three (3) years of compliance, quality assurance/audit or program/process management experience required.

Required skills

Compliance, Healthcare Compliance, Specialty Pharmacy, Pharmacy Regulatory Compliance, HIPAA, Medicare, Medicaid, 340B, Payor Credentialing, Pharmacy Licensing, Microsoft Office, Regulatory Research and Analysis

Preferred skills

Healthcare experience preferred, Experience with specialty pharmacy/pharmacy preferred

Experience

3+ years