Fuze Health logo
Fuze Health

Igniting what's possible

VP, Risk and Pharmacy Compliance

ComplianceComplianceFull TimeRemoteLeadTeam 1,001-5,000H1B No SponsorCompany SiteLinkedIn

Location

Alabama + 4 moreAll locations: Alabama | Idaho | Iowa | Texas | Wisconsin

Posted

10 days ago

Salary

$240K - $270K / year

Seniority

Lead

Bachelor Degree12 yrs expEnglish

Job Description

VP, Risk and Pharmacy Compliance

Fuze Health

• 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

Job 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

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