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From intake to outcomes, CareMetx is dedicated to delivering industry-leading patient access solutions and support services that help patients quickly start and stay on specialty therapy treatments. We provide scalable, efficient digital hub services for pharmaceutical companies and healthcare providers, streamlining workflows with seamless integration for patient enrollment, consent, and prior authorization. Our best-in-class patient support services enhance every step of care, connecting patients, providers, and brands to drive better outcomes and accelerate time-to-therapy.
Job Title: Director, Pharmacy Compliance
Location: Brooks, KY, with some hybrid flexibility.
POSITION SUMMARY:
Under the general supervision of the General Counsel & Chief Compliance Officer, the Director, Pharmacy Compliance leads the compliance program for the company's closed door specialty pharmacy operations. This role owns the pharmacy compliance framework end to end, including multi-state pharmacy licensure and board relations, HIPAA and patient privacy compliance within pharmacy operations, Anti-Kickback Statute risk assessment for free goods distribution, and adherence to applicable accreditation standards. The Director partners closely with pharmacy operations, hub services, and the broader Legal and Compliance team, and reports directly to the General Counsel & Chief Compliance Officer.
PRIMARY DUTIES AND RESPONSIBILITIES:
? Design, implement, and maintain compliance controls governing eligibility verification, program enrollment, and dispensing practices for free goods to ensure programs operate within applicable safe harbors and OIG guidance.
? Own multi-state pharmacy licensure compliance, including new state licensing, renewals, change of ownership filings, and registered agent management, in coordination with outside regulatory counsel as needed.
? Manage relationships with state boards of pharmacy, respond to inspections and inquiries, and lead remediation of any deficiencies identified, in coordination with the Pharmacist in Charge.
? Oversee HIPAA and patient privacy compliance specific to pharmacy operations, working with the Chief Privacy Officer on policies, training, and incident response.
? Serve as the subject matter expert on Anti-Kickback Statute and fraud and abuse risk as applied to a hub-plus-pharmacy integrated model distributing free goods under manufacturer sponsored programs.
? Maintain compliance with applicable accreditation standards (e.g., URAC, ACHC), including standard interpretation, audit readiness, and corrective action plans, in coordination with the Pharmacist in Charge.
? Conduct periodic risk assessments and internal audits of pharmacy operations; report findings and remediation status to the Chief Compliance Officer.
? Develop and deliver pharmacy-specific compliance training for pharmacy staff and relevant operational personnel.
? Partner with pharmacy leadership on policies and procedures governing dispensing, inventory control, and recordkeeping, including controlled substance and DEA requirements, to ensure consistency with state and federal pharmacy law.
? Monitor legislative and regulatory developments affecting closed door pharmacy operations, free goods distribution, and translate changes into practical policy updates.
? Support due diligence and integration compliance workstreams for pharmacy-related transactions.
Qualifications
EXPERIENCE AND EDUCATIONAL REQUIREMENTS:
? Bachelor's degree required.
? CHC (Certified in Healthcare Compliance) or CCEP (Certified Compliance & Ethics Professional) certification strongly preferred.
? PharmD, RPh (licensed pharmacist), or JD a plus.
? 7+ years of healthcare compliance experience, with substantial experience in pharmacy operations, specialty pharmacy, or hub services.
MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:
? Working knowledge of the Anti-Kickback Statute, False Claims Act, and OIG guidance as applied to manufacturer patient assistance and free goods programs.
? Experience with multi-state pharmacy licensing and board of pharmacy relations.
? Familiarity with HIPAA privacy requirements in a pharmacy or healthcare operations setting.
? Experience with pharmacy accreditation standards (URAC or equivalent).
? Strong written and verbal communication skills, with the ability to translate regulatory requirements into practical operational guidance.
? Demonstrated ability to work cross-functionally with operations, legal, privacy, and executive leadership.
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
? While performing the duties of this job, the employee is regularly required to sit.
? The employee must occasionally lift and/or move up to 10 pounds.
Work Environment:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Regular on-site presence at the Brooks, KY pharmacy is expected for audits, inspections, and regulatory readiness.
Schedule:
? Must be flexible on schedule and hours.
? Some travel to other pharmacy operations sites may be required.
CareMetx considers equivalent combinations of experience and education for most jobs. All candidates who believe they possess equivalent experience and education are encouraged to apply.
At CareMetx we work hard, we believe in what we do, and we want to be a company that does right by our employees. Our niche industry is an integral player in getting specialty products and devices to the patients who need them by managing reimbursements for those products, identifying alternative funding when insurers do not pay, and providing clinical services.
CareMetx is an equal employment opportunity employer. All qualified applicants will receive consideration for employment and will not be discriminated against based on race, color, sex, sexual orientation, gender identity, religion, disability, age, genetic information, veteran status, ancestry, or national or ethnic origin.