Description
We are seeking a Compliance and Operations Specialist to join our team. You will play a critical role in protecting the integrity of Express Scripts' pharmacy networks and the experience we deliver to clients and members.
Responsibilities
- Partner with contracted pharmacy providers and internal teams to research and resolve complex compliance and operational matters.
- Lead or contribute to cross-functional projects that design, test, and implement business applications, technology solutions, and process improvements.
- Analyze complex issues, identify risks and opportunities, and turn findings into clear, timely recommendations and solutions.
- Improve processes by simplifying work, automating workflows, and strengthening alignment across teams and partners.
- Monitor network provider compliance with applicable state and federal requirements, internal policies, and established procedures.
- Support client, internal, and other applicable audits by preparing information, coordinating responses, and addressing operational needs.
- Create, review, and maintain standard operating procedures, policies, training materials, and other process documentation.
- Share recommendations, concerns, and operational risks with the right stakeholders while building trusted cross-functional relationships.
- Promote operational excellence through continuous improvement, effective use of technology, and consistent execution.
Required Qualifications
- 3+ years of experience in pharmacy benefit management, pharmacy networks, healthcare operations, compliance, or a related field.
- Strong analytical, critical-thinking, problem-solving, and decision-making skills, including the ability to translate complex research into practical recommendations.
- Ability to independently manage multiple priorities, deadlines, and deliverables in a fast-paced environment with changing or unclear needs.
- Clear written and verbal communication skills, with the ability to raise questions, recommendations, concerns, and risks across levels of the organization.
- Strong organization, time management, attention to detail, sound judgment, and the ability to know when to act independently, collaborate, or escalate.
- Advanced Microsoft Excel skills, including formulas, data analysis, and pivot tables, plus proficiency with PowerPoint, Word, Access, and related business applications.
Preferred Qualifications
- Bachelor’s degree.
- Experience with regulatory requirements and industry standards related to accreditation, credentialing, delegation, or oversight.
- Experience improving processes, supporting audits, developing procedures or training, or implementing technology solutions in a regulated environment.
What We Offer
- Annual salary of 62,200 - 103,600 USD, depending on relevant factors, including experience and geographic location.
- Eligibility to participate in an annual bonus plan.
- Comprehensive range of benefits, including medical, vision, dental, and well-being and behavioral health programs.
- 401(k), company-paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence.