Director, Compliance Part D / Pharmacy Oversight
$136,400–$177,400 year
RemoteUnited States
Job Summary
Lead the design, implementation, and continuous improvement of the organization's pharmacy and Medicare Part D compliance program, ensuring adherence to federal and state regulations including CMS, DEA, and FDA rules. Monitor regulatory requirements, oversee quality reporting, formulary management, and medication-related appeals, and execute annual compliance audits while preparing for CMS program reviews. Conduct risk assessments, advise executive leadership on emerging vulnerabilities, and develop corrective action plans to mitigate compliance risks. Deliver compliance training to pharmacy staff and clinical teams, govern the internal Part D committee for Fraud, Waste, and Abuse reviews, and serve as the primary liaison with CMS, state regulators, and PBMs. Partner with operations, legal, and data analytics teams to support formulary changes and benefit design. Travel 15% of the time to local worksites, client locations, and overnight out-of-state assignments.
Required Qualifications
- Bachelor's degree
- 7–10+ years of experience in pharmacy compliance, Medicare Part D operations, PBM oversight, or related regulatory roles
- Strong knowledge of CMS Part D regulations, pharmacy benefit administration, and healthcare compliance frameworks
- Experience leading audits, managing corrective action plans, and interacting with regulators
- Deep understanding of pharmacy operations, formulary management, utilization management, and claims processing
- Strong analytical, investigative, and problem solving skills
- Excellent communication and leadership abilities
- Ability to influence cross functional teams and drive compliance culture
- High integrity, sound judgment, and commitment to ethical conduct
- Must be able to travel between local InnovAge worksites
- Must be able to travel to client and potential client homes and/or other off-site locations
- Must be able to undertake overnight travel out of state
- Must pass a background screening through the Florida Care Provider Background Screening Clearinghouse
Desired Qualifications
- Advanced degree (PharmD, MBA, MHA, JD)
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