Director, Pharmacy Compliance & Regulatory Strategy

CareMetx, LLC; United States; Hybrid; USD 140,000 - 190,000; Full time

Job summary

CareMetx seeks a Director, Pharmacy Compliance to lead the company’s closed-door specialty pharmacy compliance program. This role covers multi-state licensure, board relations, HIPAA/privacy, Anti‑Kickback risk, and accreditation readiness across operations and hub services.

You will collaborate with pharmacy operations, hub services, and Legal to ensure enterprise-wide compliance and regulatory readiness, reporting to the General Counsel & Chief Compliance Officer.

Qualifications

• Bachelor's degree required.
• CHC or CCEP certification strongly preferred.
• PharmD, RPh (licensed pharmacist), or JD a plus.
• 7+ years of healthcare compliance experience, with substantial experience in pharmacy operations, specialty pharmacy, or hub services.

Responsibilities

• Design, implement, and maintain compliance controls governing eligibility verification, program enrollment, and dispensing practices for free goods to ensure programs operate within applicable safe harbors and OIG guidance.
• Own multi-state pharmacy licensure compliance, including new state licensing, renewals, change of ownership filings, and registered agent management, in coordination with outside regulatory counsel as needed.
• Manage relationships with state boards of pharmacy, respond to inspections and inquiries, and lead remediation of any deficiencies identified, in coordination with the Pharmacist in Charge.
• Oversee HIPAA and patient privacy compliance specific to pharmacy operations, working with the Chief Privacy Officer on policies, training, and incident response.
• Serve as the subject matter expert on Anti‑Kickback Statute and fraud and abuse risk as applied to a hub‑plus‑pharmacy integrated model distributing free goods under manufacturer sponsored programs.
• Maintain compliance with applicable accreditation standards (e.g., URAC, ACHC), including standard interpretation, audit readiness, and corrective action plans, in coordination with the Pharmacist in Charge.
• Conduct periodic risk assessments and internal audits of pharmacy operations; report findings and remediation status to the Chief Compliance Officer.
• Develop and deliver pharmacy‑specific compliance training for pharmacy staff and relevant operational personnel.
• Partner with pharmacy leadership on policies and procedures governing dispensing, inventory control, and recordkeeping, including controlled substance and DEA requirements, to ensure consistency with state and federal pharmacy law.
• Monitor legislative and regulatory developments affecting closed door pharmacy operations, free goods distribution, and translate changes into practical policy updates.
• Support due diligence and integration compliance workstreams for pharmacy‑related transactions.

Skills

HIPAA compliance

Anti‑Kickback Statute

Cross‑functional collaboration

Regulatory readiness

Written & verbal communication

Pharmacy operations knowledge

OIG guidance familiarity

Compliance controls design

Education

Bachelor's degree

CHC certification

CCEP certification

PharmD

RPh license

JD

Job description

CareMetx seeks a Director, Pharmacy Compliance to lead the company’s closed-door specialty pharmacy compliance program. This role covers multi-state licensure, board relations, HIPAA/privacy, Anti‑Kickback risk, and accreditation readiness across operations and hub services.

You will collaborate with pharmacy operations, hub services, and Legal to ensure enterprise-wide compliance and regulatory readiness, reporting to the General Counsel & Chief Compliance Officer.