Lider de Regulaciones en Farmacia

Lider de Regulaciones en Farmacia

Regular

Exempt

GENERAL DESCRIPTION:

Responsible for the implementation, evaluation, analysis, and presentation of pharmacy regulatory programs derived from federal and state regulations, market and industry trend research, and the company's initiatives plans for all the company lines of business. Conducts initiative road mapping and handles the development of the initiative’s implementation annual planning processes to ensure the appropriate management. Develop, and communicate the policies and procedures of the new regulations and compliance requirements to internal and external stakeholders, and vendors ensuring that operational processes and the system reflect the necessary changes and requirements. Oversees and spearheads the efforts to ensure the attainment of high-level initiatives.

• Assesses the performance, results, and effectiveness of the initiative, as well as identifies gaps, development, and/or corrective action needs toward initiative-related processes, operations, and/or personnel. Ensure that all required processes and systems are implemented.

• Establish for each initiative a comprehensive work plan, which includes the corresponding implementation phases, projected timelines, designated process owners, and documentation of status, among other elements, to ensure the achievement of the initiatives.

• Review and update policies and procedures when there are changes in applicable laws or regulations that affect compliance requirements.

• Ensure that operational procedures are consistent with payment policies for providers and that financial systems accurately represent the regulatory data.

• Generates regulatory reports for both internal and external audits, detailing the implementation and changes of regulatory measures. reports for internal and external regulatory audits on how the regulation is being implemented.

• Acts as a liaison between Pharmacy Benefits Managers (PBM’s), Delegate Entities, and other departments of the company to ensure streamlined implementation of initiatives, including change management and transition to operations.

• Manage and resolve incidents reported from regulatory programs in pharmacies, ensuring compliance and continuous improvement through collaboration with delegated entities.

• Responsible for staying current with evolving healthcare regulations, guidelines, and industry standards.

• Develop written materials, policies and procedures, presentations, training, letters, scripts, questions, and answers in support of pharmacy initiatives implementations.

• Develop and provide training and education programs to the different teams regarding new policies and procedures, compliance requirements, regulatory updates, and best practices ensuring alignment with the regulations.
• Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices.
• May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document.

MINIMUM QUALIFICATIONS:

Education and Experience: Bachelor’s Degree in Criminal Justice, Health System Administration, Pharmacy, or related fields. At least five (5) years of experience in analyzing regulatory communications and training, healthcare compliance processes, implementing budget initiatives, market industry research, and Pharmacy Benefit Management (PBM) in the Healthcare Industry.

“Proven experience may be replaced by previously established requirements.”

Certifications / Licenses: N/A

Other: Knowledge of Medicare Part D is required. Knowledge of regulations such as Transparency in Coverage, MCAS, RX-DC, Inflation Reduction Act (Medicare Prescription Payment Plan, Medicare Drug Price Negotiation, and Manufacturer Discount Program, among others.

Languages:
Spanish – Advanced (comprehension, writing, and verbal)
English – Advanced (comprehension, writing, and verbal)

“We are an Equal Employment Opportunity Employer and take Affirmative Action to recruit Protected Veterans and Individuals with Disabilities.”