Compliance Director

Summary

Join SmithRx, a rapidly growing Health-Tech company, as their Compliance Director. You will oversee healthcare regulatory compliance, partnering with the Legal team to interpret and implement federal and state laws. Manage relationships with agencies, maintain licenses, and provide compliance training. Build and strengthen SmithRx’s compliance function. The ideal candidate possesses PBM and/or pharmacy compliance experience and a passion for transforming US healthcare. Location must be in one of the specified states. This role requires significant experience in healthcare regulatory compliance and a strong understanding of relevant laws and regulations.

Requirements

• Relevant bachelor’s or advanced degree preferred
• At least 8 years of experience in healthcare regulatory compliance or related fields
• Strong foundation in healthcare laws and regulations affecting PBMs (e.g., HIPAA, PBM/TPA licensing, utilization review laws, pharmacy laws, ERISA regulations)
• Experience interacting with government administrative agencies and regulators
• Excellent written and oral communication skills
• Ability to collaborate effectively with cross-functional teams and external stakeholders
• Highly analytical and detail-oriented, able to interpret complex regulations and provide actionable guidance
• Adept at navigating fast-paced, high-growth environments
• Comfortable operating with a high degree of independence
• Skilled at prioritizing tasks under pressure and communicating expectations clearly
• Genuine interest in improving access to affordable, convenient healthcare
• Excited by the challenge of building a compliance function at a high-growth healthcare technology company
• Applicants must be based in one of the following states: Arkansas, Arizona, California, Colorado, Florida, Georgia, Kansas, Minnesota, Missouri, Nevada, Ohio, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin

Responsibilities

• Serve as SmithRx’s HIPAA Privacy Officer and oversee HIPAA-related initiatives
• Partner with the Legal team to maintain SmithRx’s regulatory compliance posture, including managing licenses and handling required filings
• Routinely monitor federal and state laws and regulations applicable to SmithRx’s products and services and partner with department leads to develop, implement and maintain effective internal compliance controls
• Manage relationships with government regulatory agencies, responding to inquiries and ensuring compliance with reporting requirements
• Draft, revise, and update internal policies to ensure compliance with evolving healthcare regulations
• Maintain, audit, and enforce comprehensive written compliance policies and standards of conduct, including HIPAA policies and training
• Development and implement compliance training and communication plans
• Maintain a Risk Assessment program to monitor the quality and regulatory compliance of SmithRx’s services, including assisting the Pharmacy Network team with desk and field audits of contracted pharmacies
• Investigate potential violations of company policies and procedures and recommend corrective actions as needed
• Evaluate enterprise risks, propose mitigation strategies, and advise senior management on compliance, QA/RA, and risk management matters
• Monitor the creation and progress of corrective action plans resulting from both internal and external audit/investigation findings
• Collaborate with the Clinical Strategy, Pharmacy Network, and Customer Success teams to ensure new initiatives comply with applicable healthcare regulations
• Partner with the Pharmacy Network team to address state laws impacting business operations, including network design and reimbursement methods
• Provide ongoing compliance support and guidance to various internal stakeholders, fostering a culture of ethics and compliance throughout the organization

Benefits

• Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance and AD&D Insurance
• Flexible Spending Benefits
• 401(k) Retirement Savings Program
• Short-term and long-term disability
• Discretionary Paid Time Off
• 12 Paid Holidays
• Wellness Benefits
• Commuter Benefits
• Paid Parental Leave benefits
• Employee Assistance Program (EAP)
• Well-stocked kitchen in office locations
• Professional development and training opportunities