Remote Director, PBM Compliance & Regulatory Strategy

Optum; Eden Prairie (MN); Hybrid; USD 135,000 - 231,000; Full time

Job summary

Optum is seeking a Director, Compliance to lead operational compliance for PBM Commercial and Exchange lines across all states. The role requires coordinating with Legal, Regulatory, Finance, and Operations to implement scalable controls and evidence readiness.

You will drive state reforms, HIX/Transparency, and DOL-related requirements, while embedding compliance throughout design and implementation processes. Remote-friendly with optional in-office as needed in certain markets.

Qualifications

• 7+ years leadership in PBM or health-regulatory compliance across multi-state or federal implementations.
• 3+ years leading cross-functional regulatory change programs and remediation efforts.
• Working knowledge of PBM pricing, reimbursement, network, formulary, and transparency requirements.

Responsibilities

• Oversee high-impact state reforms affecting PBM transparency, reimbursement, pricing, and formulary requirements, and close readiness/go-live gaps.
• Lead resolution of implementation and control gaps identified through readiness reviews, testing, and audits.
• Provide compliance support for CAA/Transparency initiatives and HIX/Exchange readiness across all markets.
• Drive prevention and design controls to reduce regulatory findings and post-implementation issues.
• Serve as a senior escalation point for go-live events and regulator-facing matters across Commercial and Exchange operations.

Skills

Leadership

Regulatory change

PBM knowledge

Executive comms

Automation usage

Telecommuter policy

Job description

Optum is seeking a Director, Compliance to lead operational compliance for PBM Commercial and Exchange lines across all states. The role requires coordinating with Legal, Regulatory, Finance, and Operations to implement scalable controls and evidence readiness.

You will drive state reforms, HIX/Transparency, and DOL-related requirements, while embedding compliance throughout design and implementation processes. Remote-friendly with optional in-office as needed in certain markets.