VP, Risk and Pharmacy Compliance

This is a fully remote position, open to applicants in Alabama, +4 more states.

📋 Description

• Establish and manage a comprehensive pharmacy compliance and risk management program that aligns with the goals of the organization and adheres to regulatory standards.

• Act as the primary compliance advisor to executive leadership regarding pharmacy regulatory issues, compliance challenges, and emerging regulatory developments.

• Formulate and implement a long-term compliance strategy that fosters business growth while ensuring regulatory excellence.

• Foster a culture of ethics, integrity, accountability, and compliance throughout the organization.

• Guarantee adherence to relevant federal and state laws and regulations, including HIPAA, HITECH, Medicare Part D, Medicaid, state pharmacy regulations, and other healthcare compliance requirements.

• Supervise pharmacy licensing, accreditation, certification, and regulatory reporting activities.

• Lead and coordinate responses to regulatory audits, inspections, investigations, complaints, and inquiries from government agencies and pharmacy boards.

• Direct enterprise-wide pharmacy compliance risk assessments and devise risk mitigation strategies.

• Identify and proactively manage areas of regulatory risk, including drug diversion, fraud, waste and abuse, privacy, data security, and operational compliance.

• Oversee compliance monitoring, auditing, and reporting initiatives to evaluate effectiveness and discover improvement opportunities.

• Collaborate with clinical, operational, product, technology, and legal teams to integrate compliance requirements into business processes and product development.

• Provide guidance to leadership on regulatory implications related to strategic initiatives, new products, partnerships, and expansion opportunities.

• Lead, mentor, and cultivate a high-performing compliance organization.

⛳️ Requirements

• A bachelor's degree is required; an advanced degree (JD, PharmD, MPH, MBA, or a related field) is preferred.

• A minimum of 12 years of progressive experience in healthcare compliance, pharmacy compliance, regulatory affairs, or risk management in a highly regulated healthcare setting.

• Substantial leadership experience managing enterprise compliance programs and overseeing teams.

• Extensive knowledge of healthcare regulatory requirements, including HIPAA/HITECH, Medicare, Medicaid, OIG guidelines, pharmacy regulations, accreditation standards, and privacy laws.

• Experience in a senior compliance role such as Compliance Officer, Head of Compliance, VP of Compliance, or a similar position within a pharmacy, PBM, health plan, specialty pharmacy, or healthcare organization.

• Proven experience managing regulatory audits, investigations, licensing, accreditation, and enterprise risk management initiatives.

• Previous experience within a Pharmacy Benefit Manager (PBM), specialty pharmacy, health plan, or large pharmacy organization.

• Experience interacting directly with executive leadership, boards, regulators, and accrediting bodies is preferred.

• Familiarity with regulatory intelligence tools and compliance management systems is preferred.

• Experience advising organizations on compliance implications related to digital health, AI, privacy, and data governance initiatives is preferred.

• CIPP, CHC, CHPC, or a similar compliance/privacy certification is preferred.

🏝️ Benefits

• Dental, vision, and various group medical plans available.

• A 401(k) retirement savings plan.

• Group life insurance.

• Accidental death and dismemberment (AD&D) insurance.

• Flexible spending account (FSA) and health savings account (HSA).

• Commuter benefits.

• Employer-funded short-term (STD) and long-term disability (LTD) insurance.

• Additional supplemental insurance options (spouse life insurance, legal insurance, an employee assistance program, home health testing kits, and a fertility medication discount program).

• Flexible vacation time.

• Accrued paid sick time.

• 10 paid holidays.

• 2 floating holidays for full-time non-exempt employees.

• Eight weeks of paid parental leave for eligible employees.

• Additional paid weeks for the birthing parent.

• Four weeks of paid caregiver leave.

• A monthly Lifestyle Spending Account allowance.