VP, Risk and Pharmacy Compliance

Role Overview

• Establish and lead an enterprise-wide pharmacy compliance and risk management program aligned with organizational objectives and regulatory requirements
• Serve as the senior compliance advisor to executive leadership on pharmacy regulatory matters, compliance risks, and emerging regulatory trends
• Develop and execute a long-term compliance strategy that supports business growth while maintaining regulatory excellence
• Promote a culture of ethics, integrity, accountability, and compliance across the organization
• Ensure compliance with applicable federal and state laws and regulations, including HIPAA, HITECH, Medicare Part D, Medicaid, state pharmacy regulations, and other healthcare regulatory requirements
• Oversee pharmacy licensing, accreditation, certification, and regulatory reporting activities
• Lead responses to regulatory audits, inspections, investigations, complaints, and inquiries from government agencies and pharmacy boards
• Direct enterprise pharmacy compliance risk assessments and develop risk mitigation strategies
• Identify and proactively address areas of regulatory risk, including drug diversion, fraud, waste and abuse, privacy, data security, and operational compliance
• Oversee compliance monitoring, auditing, and reporting programs to assess effectiveness and identify opportunities for improvement
• Partner with clinical, operations, product, technology, and legal teams to embed compliance requirements into business processes and product development
• Advise leadership on regulatory implications associated with strategic initiatives, new products, partnerships, and expansion opportunities
• Lead, mentor, and develop a high-performing compliance organization

Requirements

• Bachelor's degree required; advanced degree (JD, PharmD, MPH, MBA, or related field) preferred
• 12+ years of progressive experience in healthcare compliance, pharmacy compliance, regulatory affairs, or risk management within a highly regulated healthcare environment
• Significant leadership experience overseeing enterprise compliance programs and managing teams
• Deep expertise in healthcare regulatory requirements, including HIPAA/HITECH, Medicare, Medicaid, OIG guidance, pharmacy regulations, accreditation standards, and privacy laws
• Experience serving as a senior compliance leader, Compliance Officer, Head of Compliance, VP of Compliance, or similar role within a pharmacy, PBM, health plan, specialty pharmacy, or healthcare organization
• Demonstrated experience managing regulatory audits, investigations, licensing, accreditation, and enterprise risk management initiatives
• Prior 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 preferred
• Familiarity with regulatory intelligence tools and compliance management systems preferred
• Experience advising organizations on compliance implications of digital health, AI, privacy, and data governance initiatives preferred
• CIPP, CHC, CHPC, or similar compliance/privacy certification preferred

Benefits

• dental, vision, and multiple group medical plans to choose from
• 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-paid short-term (STD) and long-term disability (LTD) insurance
• additional supplemental insurance plans (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
• 4 weeks paid caregiver leave
• a Lifestyle Spending Account allowance each month