Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Director Pharmacy Compliance

Blue Cross Blue Shield

## Director Pharmacy ComplianceApplylocations: US DC 9th St NWtime type: Full timeposted on: Posted Yesterdayjob requisition id: JR5889The role is responsible for managing the day-to-day pharmacy financial and audit operations. This role serves as the primary contact with the for-accounting issues and works closely with internal and external auditors. It is also the internal subject matter expert on pharmacy financial operations, directing projects and initiatives to develop strategic recommendations for improvements in pharmacy financial operations. This role manages and oversees financial aspects of over $6 Billion in yearly drug spend, ensuring vendors comply with all contractual performance guarantees.* Pharmacy Finances: Serves as the primary liaison to vendors and stakeholders, evaluates health care legislation and business trends, provides financial controls oversight, and guides contract negotiations.* Financial Compliance and Audit: Serves as the primary liaison to vendors and stakeholders for Pharmacy Programs audits. Directs cross-functional teams to enhance Pharmacy Benefit Manager compliance, negotiate favorable contracts, and ensure member benefits compliance. Coordinates with local plan divisions on waste, fraud, and abuse efforts.* Process Management: Manages bi-weekly check writes for drug spend, maintains vendor interactions, and promotes effective management across the organization.* Client Relations/External Relations: Serves as liaison and subject matter expert in the pharmacy industry with the Blue System, Government Agencies and industry representatives. The purpose of these interactions is to build professional relationships and enhance knowledge of the pharmacy industry.**The posting range for this position is:**113,572.92 - 153,590.12**Qualifications:** **Education*** Required Bachelor's Degree in either Pharmacy, Business, Economics, Management of Health Services, or equivalent work experience* Preferred Master's Degree in health services or equivalent work experience**Experience*** Required 7+ Years business experience with a national health care and managed pharmacy delivery system**Knowledge Skills and Abilities*** Leadership: Demonstrated project/program leadership, setting priorities, and achieving objectives in complex projects with multiple stakeholders.* Advanced knowledge: Financial accounting, controls, auditing, customer services, claims processing, market research, benefits delivery, quality assurance, and contract administration.* Strategic Abilities: Building organized strategies related to department/divisional goals.* Stakeholder Management: Ability to manage stakeholders, reconcile competing interests, and work in a decentralized decision-making structure.* Motivation: Highly motivated individual with an understanding of health care professionals’ interactions within the overall context of health care.* Collaboration: Incorporating perspectives from other functional areas and developing alternative approaches.* Technical Skills: Proficient in information technologies (e.g., Microsoft software applications).* Communication: Excellent written and oral communication and interpersonal skills across all levels.**Certifications & Licenses*** Preferred: CPHM - Certified Professional in Healthcare Management - AIHM* Preferred: Certified Management Accountant (CMA) - Institute of Management Accountants* Preferred: Certified Public Accountant (CPA) - Various#LI-HybridThe posted salary range is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the hiring range and this hiring range may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs. This job is also eligible for *annual bonus incentive* pay.We offer a comprehensive package of benefits *including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits* to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law. #J-18808-Ljbffr

Vacancy posted 18 hours ago
Similar jobs that could be interesting for youBased on the Director Pharmacy Compliance in Washington DC vacancy
  •  ...Blue Cross Blue Shield is seeking a Director of Pharmacy Compliance in Washington, D.C. This role is responsible for managing pharmacy financial operations and ensuring compliance with all contractual performance guarantees. The ideal candidate will have a Bachelor's Degree... 
    Suggested

    Blue Cross Blue Shield

    Washington DC
    18 hours ago
  •  ...Director, Cybersecurity Compliance Job Description Purpose & Scope: The Director of Cybersecurity Compliance leads the healthcare organization’s information security governance, risk, and compliance (GRC) program. This role is accountable for defining regulatory requirements... 
    Suggested

    VHC Health

    Arlington, VA
    4 days ago
  • $150k - $175k

     ...(MACPAC) invites you to apply for the prestigious position of Director of Finance in the vibrant heart of Washington, D.C. This is a...  ...be pivotal in ensuring the organization’s financial integrity, compliance, and strategic resource allocation. This encompasses a wide range... 
    Suggested
    Full time
    Temporary work

    Workinvirtual

    Washington DC
    4 days ago
  • $91k - $278k

     ...Andersch Ag is seeking a Director for Imports, Trade Compliance and Customs in Washington, DC. This role involves managing client engagements and leading teams focused on global trade compliance solutions. Candidates should possess over 6 years of experience and an in... 
    Suggested

    Andersch Ag

    Washington DC
    4 days ago
  •  ...increasing demand across defense, national security, public safety, and critical infrastructure markets. We are looking for a Director, SEC Compliance & Corporate Governance to help build and maintain the legal and compliance framework required to support a high-growth,... 
    Suggested

    Powerus

    Washington DC
    5 hours ago
  • $154.5k - $239k

     ...FTI Consulting Technology LLC is looking for a Data Privacy Senior Director in Washington, D.C. to deliver strategies for privacy compliance and risk management, focusing on Personally Identifiable Information. The ideal candidate will have 8+ years of post-graduate experience... 

    FTI Consulting Technology LLC

    Washington DC
    2 days ago
  • $175k - $200k

     ...The Foundation for the Defense of Democracies (FDD) is seeking a Senior Director of Finance to oversee financial operations and ensure compliance with nonprofit regulations. This hybrid role involves managing a team, leading audits, and supporting executive leadership... 

    EmergencyMD

    Washington DC
    4 days ago
  •  ...Willis Towers Watson seeks a Pharmacy Director to lead innovative pharmacy strategies and client engagements. You will be instrumental in evolving pharmacy delivery in North America, working closely with experienced consultants to deliver exceptional client value. The... 

    Willis Towers Watson

    Arlington, VA
    2 days ago
  •  ...An aerospace and defense company is seeking a Director, Global Trade Technology Management in Arlington, VA. The role involves managing...  ...'s global jurisdiction and classification strategy, ensuring compliance with relevant regulations including ITAR and EAR. Candidates... 

    Prattwhitney

    Arlington, VA
    5 days ago
  • $156.75k - $165k

     ...accounting, payroll, purchasing, risk management, and treasury management. Reporting to the Deputy CFO & Controller, the Director, Grants Compliance will steward policies governing external foreign‑funded grants, potential U.S. Grants agreements, and subawards, ensuring... 
    Flexible hours

    National Geographic

    Washington DC
    4 days ago
  •  ...Prattwhitney is seeking a Director for Global Trade Technology Management. This hybrid role requires U.S. citizenship and aims at leading...  ...jurisdiction and classification strategies while ensuring compliance with federal regulations. The ideal candidate will have extensive... 

    Prattwhitney

    Arlington, VA
    4 days ago
  • $91k - $278k

    ## Director, Imports, Trade Compliance and Customs | Forensic and Litigation ConsultingApplyremote type: Onsitelocations: Washington, DC: Indianapolis, IN: Dallas, TX: Atlanta, GA: Seattle, WAtime type: Full timeposted on: Posted 8 Days Agojob requisition id: JR260LX-TEE... 
    Full time

    Andersch Ag

    Washington DC
    5 days ago
  • $82.95k - $136.81k

     ...Director, Donor Fund Compliance The George Washington University Division of University Advancement (UA) seeks a Director, Donor Fund Compliance to develop a donor fund focused spending and compliance program. The Donor Relations team provides a comprehensive, donor... 
    Full time
    Temporary work
    Part time
    Work at office
    Remote work
    Visa sponsorship
    Work visa
    Monday to Friday

    The George Washington University

    Washington DC
    2 days ago
  •  ...RxBenefits is hiring! As part of the Revenue Operations organization, the Manager, Strategic Pharmacy Analyst (SPA), will manage a team of diverse and highly skilled analysts who are consultative business partners to our Business Development teams. This role will be... 
    Contract work
    Temporary work
    Local area
    Remote work

    RxBenefits

    Washington DC
    4 days ago
  •  ...Amtrak is seeking a Director of Enterprise Architecture Infrastructure & Compliance in Washington DC to direct alignment of technology investments with business strategy. The role involves overseeing systems solutions across various domains, collaborating with service... 

    Itlearn360

    Washington DC
    4 days ago
  •  ...Culmen International LLC is seeking a Director of Human Resources in Alexandria, VA, to lead strategic HR initiatives and ensure compliance with regulations. The ideal candidate will have over 12 years of HR experience, strong leadership skills, and the capability to manage... 

    Culmen International

    Alexandria, VA
    5 days ago
  • FGS Global is seeking a Director, Business Development focused on Compliance and Litigation in Washington, D.C. This key role involves developing strategies for law firm engagement, enhancing the firm's profile, and driving business development initiatives. The ideal candidate... 

    FGS Global

    Washington DC
    4 days ago
  •  ...A consulting firm in Arlington, Virginia, is seeking a Tax Director to manage tax provision, compliance, audits, and tax planning for national and international operations. The ideal candidate should have over 7 years of experience in Big 4 or corporate tax, with a strong... 

    Andrews & Cole, LLC

    Arlington, VA
    4 days ago
  • $200k - $250k

     ...a year and are used by more than 420,000 prescribers, 71,000 pharmacies, 270 EHRs and health information systems, and over 2,000 hospitals...  ...; we want to talk to you! Position Overview The Senior Director of Financial Planning & Analysis is responsible for leading... 
    Temporary work
    Remote work
    Flexible hours

    DrFirst

    Washington DC
    5 days ago
  • $94k - $160k

    Policy & Regulatory Affairs Manager Hybrid in Washington D.C. Where You’ll Work This position is based in our Washington D.C. office. We leverage a hybrid working model working three days in the office, two days optional remote work. What You’ll Do This position will manage...
    Work at office
    Remote work

    Children's of Alabama

    Washington DC
    5 days ago
  • $223.8k - $313.1k

    A leading health services company is seeking a Medical Director to enhance healthcare services, ensuring alignment with CMS guidelines...  ...include reviewing clinical cases for medical necessity and compliance, supporting organizational excellence, and participating in educational... 
    Remote job
    Work at office

    Humana Inc

    Washington DC
    2 days ago
  • $80k - $115k

    Shelterforce Magazine is seeking a Program Director or Manager to lead the administration of the PRICE grant from HUD. The successful candidate will manage grant compliance and work closely with stakeholders to advance affordable homeownership initiatives. The role involves... 
    Remote job

    Shelterforce Magazine

    Washington DC
    6 days ago
  •  ...Chapter 13 Trustee Middle District of Alabama is looking for a Director of Audits and Tax Compliance based in Washington, DC. This position leads audits and compliance for the Environmental Defense Fund, ensuring financial integrity and regulatory compliance. The job requires... 

    Chapter 13 Trustee Middle District of Alabama

    Washington DC
    4 days ago
  • $156.75k - $165k

     ...National Geographic is seeking a Director, Grants Compliance to oversee the grant lifecycle, ensuring compliance with donor laws and internal policies. The candidate will act as a liaison for grant guidelines, manage proposals, and conduct risk assessments. Applicants... 

    National Geographic

    Washington DC
    5 days ago
  •  ...OpenAI is looking for an experienced Regulatory & Product Assurance IC to enhance its Governance, Risk, and Compliance (GRC) function across product launches and regulatory readiness. You'll partner with various teams to ensure compliance claims remain accurate while... 

    OpenAI

    Washington DC
    1 day ago
  • $109.45k - $144.04k

    Young World Physical Education in Alexandria, Virginia is hiring an Assistant Director of Specialized Instruction. The role involves overseeing compliance with special education regulations, managing the Child Find process, and directing Medicaid reimbursement efforts.... 
    Full time

    Young World Physical Education

    Alexandria, VA
    4 days ago
  • A leading affordable housing organization is seeking a Vice President of Compliance to provide strategic leadership and operational oversight for a large multifamily portfolio. This executive will guide the compliance strategy and lead teams while ensuring adherence across... 

    MSB Resources

    Washington DC
    5 days ago
  •  ...The American Association for Cancer Research is seeking a Director, Regulatory Science and Policy to lead initiatives impacting cancer research policy. You will work closely with the VP of Science Policy and Government Affairs to advance regulatory science efforts and... 

    American Association for Cancer Research

    Washington DC
    4 days ago
  •  ...letter is optional, but we encourage you to submit one and share why this role interests you. Position Overview The Director of Audits and Tax Compliance leads Environmental Defense Fund's external and program audits as well as nonprofit tax reporting functions to ensure... 
    Full time
    Work at office
    Local area

    Chapter 13 Trustee Middle District of Alabama

    Washington DC
    4 days ago
  •  ...Corporate Director, Technical Accounting & SOX Compliance Location: Arlington, Virginia, United States US Citizenship Required: Yes Employment: Full-Time Shift: 1st Relocation: Relocation assistance will be available Virtual/Telework Opportunity: No - Not eligible for... 
    Full time
    Contract work
    Work experience placement
    Work at office
    Local area
    Remote work
    Relocation
    Relocation package
    Shift work

    Huntington Ingalls Industries

    Arlington, VA
    4 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Director Pharmacy Compliance. Be the first to apply!