Licensing Compliance Manager

Exemption Status:

United States of America (Exempt)

Exemption Status:

$81,581 - $110,136 - $138,690

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

Verdegard is looking for extraordinary people to join our team!

Why join Verdegard? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

Job Description

Summary 

As a Licensing Compliance Manager, you will play a pivotal role in ensuring the company's adherence to all relevant regulations and licensing requirements. Your primary responsibilities will include maintaining the compliance calendar, filing timely reports to government agencies, addressing inquiries, collaborating with the management team to uphold filing requirements, and contributing to the development of internal controls and policies.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

Maintain Compliance Calendar:

• Develop and manage a comprehensive compliance calendar to track monthly, quarterly, and annual filing deadlines.

• Ensure timely completion of all compliance-related tasks to meet regulatory obligations.

• Government Reporting:

• File accurate and timely reports to relevant government agencies in accordance with local, state, and federal regulations.

• Stay informed about changes in regulatory requirements and adjust reporting processes accordingly.

Inquiry Handling:

• Assist in addressing inquiries from governmental agencies promptly and accurately.

• Collaborate with internal stakeholders to gather necessary information and ensure a coordinated response.

• Collaboration with Management: Work closely with the management team to keep the entire company informed and up to date on all local, state, and federal filing requirements.

• Provide guidance on compliance matters and contribute to decision-making processes.

Internal Controls, appropriate audit oversight, and Policies:

• Assist in developing and implementing internal controls and policies to ensure comprehensive corporate compliance.

• Conduct regular assessments to identify areas of improvement and recommend enhancements to existing processes.

• Appeal Process Engagement:

• Ensure an efficient and effective appeal process to address adverse claims requests.

• Monitor the appeals workflow, track outcomes, and provide insights for continuous improvement.

Supervisory Responsibilities        

Manages assigned staff in the segment area. Responsible for the overall direction, coordination, and evaluation of the unit. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. Supports and enforces all company policies and procedures in a fair and consistent manner, taking corrective action whenever necessary.

Education and/or Experience

BS/BA degree or equivalent plus 5+ years of experience; 1 year of SME in respective area(s); and 3+ years of supervisory experience; 4 years of MedImpact experience plus an appropriate external leadership training program and internal mentorship with a seasoned leader (Dir+) that must completed within 12 months in new position may substitute for the supervisory experience requirement.

Computer Skills

To perform this job successfully, an individual should have expert skills of Microsoft Office Suite, especially Excel, Word, and PowerPoint. 

Certificates, Licenses, Registrations

None required

Other Skills and Abilities

 Excellent skills in written and oral communication; organization/prioritization; decision-making; problem analysis and resolution; negotiation; team building; and leadership. Ability to maintain a high degree of confidentiality using, tact, discretion, and professionalism in all aspects of the job.  Strong attention to detail and follow-through skills.

Reasoning Ability

• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.

• Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

• Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems. 

• undefined

Mathematical Skills

• Ability to work with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry. 

• Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.

Language Skills    

• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. 

• Ability to write routine reports and correspondence.  Ability to speak effectively before groups of customers or employees of organization.

Competencies To perform the job successfully, an individual should demonstrate the following competencies:

Building Effective Teams

Decision Quality

Informing

Confronting Direct Reports

Delegation

Organizational Agility

Customer Focus

Drive for Results

Political Savvy

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Ability to maintain clear near visual acuity at approximately 20 inches or less (i.e., “close vision”) to accurately read fine print, view computer screens, and handle small objects. Requires adequate color vision and depth perception to support safety and precision in detail-oriented tasks.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes, or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic).

Work Location

This position works on-site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders.

Working Hours

This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, weekends or on holidays as required. Work hours may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm.

Travel

This position requires domestic travel of up to 25% of the time.

The Perks:

• Medical / Dental / Vision / Wellness Programs

• Paid Time Off / Company Paid Holidays

• Incentive Compensation

• 401K with Company match

• Life and Disability Insurance

• Tuition Reimbursement

• Employee Referral Bonus

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/Veterans

OSHA/ADA:

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are
representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.