Senior Advisor, Pharmacy & Care Delivery Compliance- (Remote)

📋 Description

• • Conduct audits and monitoring activities quarterly for Evernorth Care Delivery, Pharmacy, Home Infusion Nursing, and Wholesale Drug Distribution to ensure regulatory compliance.
• • Manage the Prompt Response and Corrective Action Program, ensuring timely identification, documentation, and remediation of compliance issues.
• • Lead and facilitate compliance committee meetings with business stakeholders to align on risk mitigation and regulatory adherence.
• • Develop and execute auditing and monitoring plans focused on high-risk areas within pharmacy operations and care delivery.
• • Create and maintain dashboards and status reports that communicate audit findings, compliance trends, and remediation progress to business leaders.
• • Deliver executive-level compliance reports summarizing key findings, risks, and action plans to senior stakeholders.
• • Serve as a subject matter expert on federal, state, and local healthcare regulations, particularly regarding pharmacy operations, controlled substances (DEA), home infusion, and drug distribution.
• • Ensure full compliance with HHS OIG General Compliance Program Guidance (GCPG) across all applicable operations.
• • Advise business units on regulatory risk, compliance requirements, and mitigation strategies to support informed decision-making.
• • Research and respond to compliance inquiries in collaboration with Legal and Compliance teams.
• • Update, revise, and maintain departmental policies and procedures, and support reviews of policies for supported business units.
• • Support business partners in issue management and resolution by providing clear, actionable guidance rooted in regulatory frameworks.
• • Execute training strategies to educate business stakeholders on compliance topics relevant to care delivery and pharmacy operations.
• • Collaborate with Internal Audit, Legal, and operational teams to support investigations, regulatory inquiries, and remediation efforts.
• • Conduct annual assessments of the compliance program’s effectiveness to identify gaps and recommend enhancements.
• • Stay current on industry trends, regulatory changes, and emerging compliance risks impacting pharmacy and care delivery functions.
• • Maintain accurate records and documentation for all compliance activities, audits, and corrective actions to support regulatory readiness.
• • Operate with a high degree of independence while managing multiple priorities in a complex, highly regulated environment.
• • Ensure internet connectivity meets minimum requirements of 10Mbps download/5Mbps upload for remote work.
• • Travel to company sites and supporting locations as needed to support compliance activities and stakeholder engagement.