Director, PBM Compliance and Regulatory Affairs

This is a fully remote position, open to applicants in Colorado, +3 more states.

📋 Description

• Conduct regulatory research at both federal and state levels while anticipating business needs and requirements.

• Recognize and convey potential risks, and develop policies, procedures, and strategic plans to address these risks.

• Prepare, submit, and oversee business registrations and licenses, including the necessary reporting obligations.

• Collaborate with department leaders on compliance initiatives related to statutory, regulatory, pharmacy, and PBM matters.

• Design and uphold regulatory and legislative compliance plans.

• Establish, implement, and sustain effective internal controls, policies, and procedures.

• Ensure that vendor and client contract terms adhere to state and federal regulations.

• Monitor and communicate policies, procedures, performance metrics, reporting requirements, and key indicators.

• Act as the compliance subject matter expert on mandated projects and escalated issues.

• Keep up-to-date with regulatory affairs across relevant jurisdictions.

• Spearhead the development of company positions and responses regarding pending regulatory initiatives.

• Create and execute training and communication strategies.

• Oversee compliance projects and offer consultation services to various departments.

• Provide strategic compliance leadership and guidance to clients and business partners.

• Identify and implement improvements in regulatory processes.

• Lead internal and external regulatory audits and manage responses to findings.

• Mentor and develop a team of compliance professionals and leaders.

⛳️ Requirements

• A Bachelor’s Degree is required.

• JD (Juris Doctorate) degree or an equivalent combination of practical experience is necessary.

• At least 7 years of pertinent work experience in the healthcare sector.

• Experience in the PBM industry is preferred.

• Must be detail-oriented, analytical, intellectually curious, a good listener, empathetic, capable of challenging the status quo, and a values exemplar.

• Strong communication, research, and organizational abilities are essential.

• Should possess the capability to lead projects and influence others, even without direct ownership of reporting lines.

• Must be able to work independently and manage multiple projects in a dynamic, fast-paced environment.

• Advanced computer and Windows proficiency is required.

🏝️ Benefits

• Bonus.

• Equity.

• Equal Opportunity Employer promoting an inclusive culture.