Compliance Associate

Job Description

Job Description

bout the Role

The Compliance Associate plays a key role in ensuring the organization adheres to all applicable federal and state regulations, contractual obligations, internal policies, and standard operating procedures (SOPs)—with a strong focus on Medicare-related requirements.

This role supports the development, implementation, and oversight of comprehensive compliance programs aimed to :

Mitigate risk

Uphold regulatory standards

Promote ethical business practices

The Compliance Associate will collaborate across departments to identify potential compliance risks, conduct audits, and assist in investigations—helping safeguard the organization and its patients from legal and regulatory challenges.

Essential Roles and Responsibilities

Draft agreements, amendments, and legal documents according to company guidelines.

Track execution and filing of legal and regulatory documents.

Review applicable Medicare and state regulations and coordinate required filings with regulatory agencies.

Monitor and interpret regulatory updates impacting PBM operations (e.g., CMS, HIPAA, Medicare Part D).

Assist in maintaining compliance with Medicare requirements, including formulary management, reporting, and audit readiness.

Conduct periodic internal audits to ensure compliance with established procedures.

Prepare and disseminate compliance-related policies, procedures, and reports.

Maintain documentation of compliance activities, including complaints and investigations.

Collaborate with departments to ensure timely document handling and compliance actions.

Provide employee training on compliance-related topics.

Support internal and external audits (URAC, SAE 16, CMS).

Prepare management reports on compliance performance and initiatives.

Ensure firm and regulatory policies are documented, implemented, and communicated effectively.

Recommend and update policies to align with new regulations and standards.

Perform other duties as assigned by the Compliance Director.

Qualifications

Education & Training

Bachelor’s degree in Healthcare Administration, Law, or Paralegal Studies required.

Certified Compliance & Ethics Professional (CCEP) certification preferred.

Professional Experience

1–3 years of experience in a PBM or Health Plan environment and / or Medicare-related programs.

1–2 years of experience working with contractual agreements.

Competencies

Knowledge

Fully bilingual in English and Spanish.

Strong understanding of CMS regulations and Medicare compliance standards.

Proficient in Microsoft Office 365 (Word, Excel, PowerPoint).

Familiarity with business processes, compliance documentation, and report preparation.

Skills & Attributes

Excellent organizational, analytical, and problem-solving skills.

Strong verbal and written communication skills.

Integrity, discretion, and commitment to ethical practices.

Strategic and critical thinking.

Effective time management and prioritization.

Ability to deliver engaging, professional presentations and adapt communication to diverse audiences.

Client-focused and collaborative approach.

Equal Opportunity Employer / Disabled / Protected Veterans

The Know Your Rights poster is available here :

https : / / www.eeoc.gov / sites / default / files / 2023 -06 / 22- 088_EEOC_KnowYourRights6.12.pdf

The pay transparency policy is available here :

https : / / www.dol.gov / sites / dolgov / files / ofccp / pdf / pay - transp_%20English_formattedESQA508c.pdf

For temporary assignments lasting 13 weeks or longer, the Company is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.

https : / / e- verify.uscis.gov / web / media / resourcesContents / E - Verify_Participation_Poster_ES.pdf

We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants : Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

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Company Description

This company offers growth and a great group of people to work with.

Company Description

This company offers growth and a great group of people to work with.