United States onlySr. Manager, Pharmacy Operations Compliance – Remote
The Sr. Manager, Pharmacy Operations Compliance is responsible for tracking, monitoring, reviewing, interpreting, and communicating all aspects of existing, proposed, and newly enacted federal and state rules and regulations, Joint Commission (JC) accreditation standards, and Centers for Medicare and Medicaid (CMS) Conditions of Participation relative to the practice of pharmacy within the organization. Collaborates with the organization’s management and pharmacists who are responsible and accountable for decisions affecting successful JC accreditation, compliance with enacted federal and state rules and regulations and CMS Conditions of Participation. Participates in the development of policies and procedures related to applicable pharmacy accreditation standards and compliance with federal and state rules and regulations. This is a US based remote role.
Responsibilities:
- Serve as subject matter expert to pharmacy staff and provide broad oversight for pharmacy regulatory standards, federal and state rules and regulations, state residency and licensing requirements, pharmacy-specific accreditations held, and voluntary regulatory standards and their interpretations.
- Collaborate with enterprise-wide Pharmacy leadership to identify and initiate improvements to ensure compliance with existing and evolving regulatory standards, federal and state rules, and regulations.
- Maintain subject matter knowledge and expertise and enhance knowledge of the above standards, rules, and regulations that relate to pharmacy services.
- Complete gap analyses for compliance with additions and changes to the standards, rules, and regulations and assess potential organizational impact.
- Direct activities to remediate gaps to ensure ongoing compliance with pharmacy regulations.
- Develop and/or update policies and procedures whenever additions and changes to standards, rules, or regulations warrant, as well as align internal policies and procedures to corporate standards.
- Recommend training requirements for pharmacy compliance to the corporate compliance training program.
- Provide timely and accurate communication and training, as needed and as appropriate, regarding the interpretation of policy/procedure additions, changes, and timelines for compliance.
- Provide oversight to ensure that state licensing and residency requirements are met and maintained.
- Participate in the selection of vendors and/or personnel to be used to manage the day-to-day operations of licensing pharmacy personnel, and direct activities to ensure licensing requirements are maintained for each participating pharmacist at the organization.
- Collaborate with members of the corporate leadership team and other departments within the company to direct compliance issues to appropriate resources for resolution. Act as an independent reviewer and evaluator to ensure that compliance issues and concerns within the organization are being appropriately evaluated, investigated, and resolved.
- Identify potential areas of compliance vulnerability and risk, develop, and implement corrective action plans for the resolution of problematic issues, and provide general guidance on how to avoid or deal with similar situations in the future.
- Monitors the performance of the Pharmacy Operations Compliance Program and related activities on a continuing basis, taking appropriate steps to improve its effectiveness.
- Collaborate with Quality Assurance to ensure compliance with URAC and/or NCQA accreditation conditions are met.
- Responsible for leading Pharmacy compliance oversight meetings
Basic Qualifications:
- Bachelor’s degree from an accredited college. In lieu of a degree, 10 years of comparable work experience is acceptable.
- Work experience with computerized pharmacy information and dispensing systems, operations, and clinical pharmacy services.
- Working Knowledge of Pharmacy Operations Compliance in the following areas:
- CMS compliance
- Controlled Substances Act compliance
- Billing and coding process compliance
- Healthcare fraud, waste and abuse compliance
- 340B Program compliance
- Pharmacy and pharmacist licensing
- State BOP Compliance, Implementation of said regulations, seeing if regulations apply and then working with ops to implement regulations.
- Drug Supply Chain Security Compliance
- Implementation/leading pharmacy operations compliance training
- Auditing - Both Internal and External
- Specialty pharmacy operations knowledge
- Identify regulatory compliance risks within the pharmacy and developing a plan to mitigate those risks
Preferred Qualifications:
- Experience with Infusion and compounding services
- Proficient in Microsoft office and Smartsheet
- As Passionate Transformers, we find a better way to innovate relentlessly.
- Being Mission Driven, we consistently deliver on our promises.
- Our Entrepreneurial spirit makes the most of EVERY opportunity for innovation.
- Understanding that Relationships Matter creates synergies that yield the greatest benefits for all.
- In Doing the Right Thing, we lead by example in ALL we do.
We value creating an inclusive culture and a healthier world through ESG initiatives, Employee Impact Groups, learning, well-being programs, and more. Join us in transforming the pharmacy care delivery model, making patient care safer and smarter for all.
