Job Details

Pharmacy Compliance Director

Company name

CIGNA

Organization Type

In-House

Job Type

Attorney

Years of Experience

Min 15 yrs required

Location

Bloomfield, CT

Date Last Verified

Dec 11,2017

Posted on

Jul 19,2017
Practice Area
Insurance Coverage >> Insurance Coverage
Apply for this job
 
Your Email:
Upload Resume:

 
218 hits

Profile

Pharmacy Compliance Director The candidate's responsibilities: Ensures identification of regulatory expectations: Identifies all regulatory requirements applicable to Pharmacy business. Ensures development of policies and standards identifying company's expectations regarding those regulatory requirements. Ensures proactive relations with regulators and other government officials – independently or through Government Relations – designed to understand regulatory expectations as well as influence regulatory decision making that is the best interest of company's Pharmacy customers and clients. Exhibits knowledge of and the ability to advise on regulations specific to the Pharmacy business. Ensures regulatory risk management: Proactively identifies risks of non-compliance applicable to Pharmacy segment operations and associates – including vendors, contractors, related parties and other providers of services necessary to implement Pharmacy business. Facilitates the development and understanding of Pharmacy business’s risk appetite for non-compliance that aligns to company's Board and ELT risk appetite. Maintains a risk register and risk mitigation plan for maintaining or restoring compliance within company and Pharmacy segment’s risk tolerance. Ensures development of procedures and controls: Ensures Pharmacy’s development of appropriate procedures to carry out and control operations and conduct in conformance with regulatory polices and standards all within company's regulatory compliance risk appetite. Partners with Pharmacy leadership to optimize the ability to execute on Pharmacy’s strategic and financial objectives while maintaining compliance. Works to identify unique and innovative approaches that satisfy regulatory stakeholder expectations while maximizing operational efficiency, financial results, and consumer satisfaction. Facilitates optimization of the number, depth, and impact of regulatory compliance controls in coordination with other oversight groups (financial audit, CIP, etc.). Ensures appropriate monitoring and auditing of Pharmacy business’s compliance activities: Ensure monitoring of key compliance metrics through development of Pharmacy compliance scorecard that aligns to Enterprise Compliance’s expectations. Establishes with US BU CO and Pharmacy leadership appropriate metric thresholds for identifying non-compliance. Ensure Training and Education: Ensures that general compliance program training and education is provided to all Pharmacy associates, contractors, and vendor associates. Ensure that specialized regulatory training needs are identified, developed, and delivered. Ensures US BU CO, CCO, ELT, and Board Are Informed: Ensures development of Pharmacy business’s monthly reports, which are used to inform the ELT and Board are informed of risks that exist in the Pharmacy business. Ensures Appropriate Investigations and Disciplinary Action: Supports the identification of matters that require investigation and potential disciplinary matters. Per company's policies, may lead or assist in investigations of non-compliance and provide findings and recommendations to the appropriate decision makers. Ensures Corrective Actions Are Appropriately Implemented: Oversees necessary improvements in regulatory risk identification, internal controls development, and compliance metrics. Evaluates appropriateness of corrective action timeliness and delays. Assists in prioritization of resource deployment for addressing compliance related correction actions and operational improvements while taking into consideration competing demands from business units and other oversight groups regarding strategic, operational, customer, financial and compliance needs. Ensures Execution of a Comprehensive Compliance Program Effectiveness Plan: Ensures coordination of oversight needs across corporate units including Enterprise Compliance, Legal, Privacy Office, Enterprise Risk Management, Internal Audit, etc. Facilitates thought leadership and coordinated implementation of company's-wide tools to streamline and optimize compliance process management to include common policy and standards repository, coordinated training programs, shared service organizations and other activities. Ensures development of a Pharmacy segment Compliance Program Effectiveness Plan which meets company, State, Federal Sentencing Standards, and other regulatory stakeholder requirements.

Qualification and Experience

The candidate should have J.D. degree and/or Doctor of Pharmacy. Should have 15+ years of experience in insurance and/or retail pharmacy and a good working knowledge of Pharmacy organization’s business processes. Demonstrated experience providing Executive Leadership Team level reporting. Excellent written and verbal communication skills with the ability to tailor written and verbal communication across a variety of audiences. Proven track record of program management, including effective leadership and on time execution of strategic and tactical objectives.

Additional info

Ref - 17005967

Company info

Apply Now

Similar Jobs:

Head of Medicare Business Support (Compliance Director) Duties: Reports to the Medicare/Medicaid Chief Compliance Officer (“MMCCO”). Responsible for leading all the day-to-day compliance initiatives and workstreams that focus...
Director, Compliance Investigations The candidate will be responsible for initially assessing, and, as warranted, investigating internal and external allegations and reports regarding potential violations of, among other things, ...
Regulatory Staff Attorney The candidate will provide legal support for legal, regulatory and compliance matters on a broad spectrum of issues that arise under state and federal insurance and related laws, with an emphasis as to t...