Who We Are:

EmpiRx Health is the leading clinically-driven pharmacy benefits management company. As the pioneer in value-based pharmacy care, EmpiRx Health puts its customers and members first by enabling them to take control of their pharmacy benefits, healthcare outcomes, and financial results.

What We Do:

We place more emphasis on member care than any other PBM by focusing on health outcomes first. Our pharmacists and clinicians are at the center of everything we do―and our population health solution delivers tailored strategies for our clients.

Leveraging our newly launched, AI-powered pharmacy care platform, Clinically™, EmpiRx Health’s pharmacists and client management teams provide the highest quality pharmacy care to our clients and their members. This enables benefits plan sponsors to keep their members healthy, happy, and productive, while substantially reducing prescription drug spending, which has been on an explosive growth trajectory in recent years.

Who We're Looking For:

EmpiRx Health is in unprecedented growth, and we're seeking to add a Director of Compliance to our team. This role will report to Chief Legal Officer and provide operational leadership pertaining to compliance and regulatory issues as well as manage an enterprise wide comprehensive compliance program. The actual position title will depend on the experience level of the successful candidate. The Senior Director of Compliance is responsible for tracking, monitoring, reviewing, interpreting, and communicating all aspects of existing, proposed, and newly enacted federal and state rules and regulations relating to Pharmacy Benefit Managers. Drive and execute the development of policies and procedures related to applicable licensing and accreditation standards and compliance with federal and state rules and regulations including privacy laws.

What You'll Do:

Oversee departmental workflow procedures as they relate to regulatory compliance and keeping the company up-to-date regarding state/federal regulations and compliance obligations.
Effectively translates regulatory guidance into streamlined operational processes to ensure compliance, at times with short notice.
Develop and maintain working knowledge of rules, and regulations that relate to PBM and health plans, their interpretation, current trends and issues, and timelines for compliance.
Tracks and disseminates laws and regulations that affect the organization's policies.
Complete gap analyses for compliance with additions and changes to the standards, rules, and regulations and assess potential organizational impact.
Develop and oversee the Enterprise overall Policy & Procedure process, and update related policies and procedures to ensure adherence to rules and regulations relating to the business.
Provide timely and effective annual training sessions to employees on policies and procedures.
Develop, direct and maintain responsibility for the corporation's compliance function and business ethics related to standard of conduct, including HIPAA privacy and security compliance.
Lead and prepare investigations related to compliance and privacy issues in an accurate manner, notifying affected parties in a timely manner.
Oversee, execute and prepare the acquisition and maintenance of required licenses (PBM, TPA and UR), and certificates from appropriate state and federal entities on a timely manner. Maintain and track reporting on licensing to ensure appropriate filings are provided to state regulators.
Collaborate with clinical, data analytics and client team and other stakeholders as needed, to identify and initiate improvements to ensure compliance with existing and evolving federal and state rules and regulations.
Provides real-time guidance to business units and subsidiaries related to multiple potential compliance issues.
Oversees the development and operation of compliance monitoring and auditing (i.e., compliance assurance program)
Manages any investigations of alleged violations of law, policies and procedures, and the Company’s Code of Conduct and Conflict of Interest policies.
Manage and assists in the development, tracking and completion of corrective action plan.
Manages the Enterprise Accreditation processes, on-going requirements and the annual re-accreditation processes
Lead Audit function in conjunction with other stakeholders to ensure compliance.
Participate in Enterprise leadership committees as indicated, including but not limited to Quality Management, Compliance, and others.
Other ad hoc activities and projects as assigned.

What You Need:

Bachelor’s degree, Health Care, or related are of study required. Advanced Degree preferred.
Certified Compliance and Ethics Professional or Certified in Healthcare Compliance (CHC preferred.
8+ years of compliance related & management experience in the PBM/Health Plan environment. Candidates with other healthcare experience (health plans,) may be considered.
Experience with broad spectrum PBM offerings and associated potential regulatory issues.
Self-starter with the ability to define, coordinate and direct assignments of team members.
Strength in leading and managing teams of compliance professionals working in a high growth business.
Ability to translate complex regulatory issues and risks into understandable concepts the team and other individuals with non-legal backgrounds
Excellent interpersonal, collaborations, communication, (verbal and written) and presentation skills essential.

Additional Qualifications

Solid interpersonal skills and Team player
Highly motivated with the ability to support timely decisions

Why Join Us:

EmpiRx Health is on an extraordinary journey where excellence meets innovation.
We are a collaborative team that encourages groundbreaking ideas, values open dialogue, and prioritizes continuous improvement.
You will be part of a dynamic team where success is a shared celebration, collaboration fuels progress, and we redefine healthcare together.
We offer a generous and competitive benefits package.
You will share in the company's success through our discretionary bonus program.

EmpiRx Health is an Equal Opportunity Employer

EmpiRx Health is an equal opportunity employer. We are committed to creating a diverse and inclusive environment for all employees. We prohibit discrimination and harassment of any kind based on race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

All employment decisions are based on business needs, job requirements, and individual qualifications. We are an inclusive organization and actively promote equality of opportunity for all with the right mix of talent, skills and potential. EmpiRx Health celebrates diversity and is committed to creating an inclusive environment for all employees.

Your career at EmpiRx Health awaits – join us in shaping the future of excellence in healthcare.

Senior Director of Compliance

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