Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.nnJob Posting TitlennRegulatory Analyst - RemotennJob DescriptionnnThe Regulatory Analyst is responsible for leading portions of regulatory assessment, external audits and accreditation processes within the Commercial, Medicare, Medicaid, and Health Insurance Marketplace for the assigned department. This position is responsible for primary point of contact for internal and external business partners regarding related regulatory activity and quality efforts involving utilization and/or medication therapy management, client delegation agreements and accreditation entities, SOP development and maintenance.nnResponsibilitiesnnParticipate in portions of external audits as directed by the Centers for Medicare & Medicaid Services (CMS), Medicaid, NCQA, participate in commercial and Client driven external audits, annual reviews, and pre-delegation reviews and lead assigned department (i.e. Clinical Operations, PBM Operations) portions of ongoing Accreditation processesnnAssist in Regulatory Review Committee Meetings, Healthcare Reform Meetings, Regulatory Oversight Meetings, CMS User Calls, and Government Programs Compliance Committee Meetings to monitor new regulations and provide necessary updates to these committeesnnLead the Client, external auditor, and/or accreditation reviewer through Prime’s business processes and provide the appropriate documentation and/or data files as they relate to accreditation standards or regulationsnnMaintain regulatory and accreditation gap status reporting to keep all constituencies informed; track, manage, and report on work stream status against plannnLead all efforts for response to inquiries related to the assigned department, which may include pulling pertinent case files/samples, validating regulatory requirements, and review and validation of processes against requirementsnnTake lead on change management related to regulatory requirementsnnOther duties as assignednnRequired QualificationsnnBachelor’s degree in business, finance, health services or related area of study, or equivalent combination of education and/or relevant work experiencenn3 years of PBM, healthcare, and/or compliance work experiencennMust be eligible to work in the United States without need for work visa or residency sponsorshipnnAdditional QualificationsnnStrong verbal and written communication skillsnnDemonstrated critical thinking and analysis skills with the ability to interpret regulations into operational requirementsnnStrong attention to detail and commitment to meeting established timelinessnnPreferred QualificationsnnDemonstrated knowledge of CMS regulations, Health Care Reform and Federal healthcare reporting requirementsnnProficient in standard software (Word, Visio, and Excel)nnMinimum Physical Job RequirementsnnConstantly required to sit, use hands to handle or feel, talk, and hearnnFrequently required to reach with hands and armsnnOccasionally required to stand, walk and stoop, kneel, and crouchnnOccasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 poundsnnSpecific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focusnnReporting StructurennReports to a manager or director in the Clinical Operations, Contact Center, Network Management or PBM Operations departmentnnPotential pay for this position ranges from $64,700.00 - $97,100.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.nnTo review our Benefits, Incentives and Additional Compensation, visit our Benefits Page ( and click on the "Benefits at a glance" button for more detail.nnPrime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.nnWe welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.nnPrime Therapeutics LLC is a Tobacco-Free Workplace employer.nnPositions will be posted for a minimum of five consecutive workdays.nnPrime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.nnIf you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.nnPrime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.nnWe welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.nnPrime Therapeutics LLC is a Tobacco-Free Workplace employer.nnIf you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email