What are the responsibilities and job description for the Compliance Director position at SmithRx?

Who We Are :

SmithRx is a rapidly growing, venture-backed Health-Tech company. Our mission is to disrupt the expensive and inefficient Pharmacy Benefit Management (PBM) sector by building a next-generation drug acquisition platform driven by cutting edge technology, innovative cost-saving tools, and best-in-class customer service. With hundreds of thousands of members onboarded since 2016, SmithRx has a solution that is resonating with clients all across the country.

We pride ourselves on our mission-driven and collaborative culture that inspires our employees to do their best work. We believe that the U.S healthcare system is in need of transformation, and we come to work each day dedicated to making that change a reality. At our core, we are guided by our company values :

Integrity : Always operate with honesty and transparency so we earn the trust of our clients.
Courage : Demonstrate the courage needed to take on a broken industry and continuously improve what we offer to optimize health outcomes.
Together : Foster a collaborative and inclusive environment that values teamwork, respect, and open communication, and encourages creativity and diversity of thought.

Job Summary :

As the Compliance Director, you will be responsible for overseeing healthcare regulatory compliance issues that impact SmithRx. In a dynamic and rapidly changing regulatory landscape for PBMs, you will partner closely with our Legal team to interpret and operationalize federal and state laws across various functions, including Clinical Strategy, Pharmacy Network, and Customer Success.

You will manage relationships with administrative agencies and regulators, maintain required licenses and reporting obligations, and respond to inquiries. Additionally, you will provide guidance on strategies to ensure compliance and train colleagues across the company.

You will play a key role in building and strengthening SmithRx's compliance function. The ideal candidate will have PBM and / or pharmacy compliance experience and a genuine passion for transforming the U.S. healthcare system.

In order to be eligible for this position applicants must be based in one of the following states : Arkansas, Arizona, California, Colorado, Florida, Georgia, Kansas, Minnesota, Missouri, Nevada, Ohio, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin.

What you will do :

Regulatory Compliance & Oversight

Serve as SmithRx's HIPAA Privacy Officer and oversee HIPAA-related initiatives.

Partner with the Legal team to maintain SmithRx's regulatory compliance posture, including managing licenses and handling required filings.

Routinely monitor federal and state laws and regulations applicable to SmithRx's products and services and partner with department leads to develop, implement and maintain effective internal compliance controls.

Manage relationships with government regulatory agencies, responding to inquiries and ensuring compliance with reporting requirements.

Compliance Programs & Policy Development

Draft, revise, and update internal policies to ensure compliance with evolving healthcare regulations.

Maintain, audit, and enforce comprehensive written compliance policies and standards of conduct, including HIPAA policies and training.

Develop and implement compliance training and communication plans.

Quality Assurance & Risk Management

Maintain a Risk Assessment program to monitor the quality and regulatory compliance of SmithRx's services, including assisting the Pharmacy Network team with desk and field audits of contracted pharmacies.

Investigate potential violations of company policies and procedures and recommend corrective actions as needed.

Evaluate enterprise risks, propose mitigation strategies, and advise senior management on compliance, QA / RA, and risk management matters.

Monitor the creation and progress of corrective action plans resulting from both internal and external audit / investigation findings.

Cross-Functional Collaboration

Collaborate with the Clinical Strategy, Pharmacy Network, and Customer Success teams to ensure new initiatives comply with applicable healthcare regulations.

Partner with the Pharmacy Network team to address state laws impacting business operations, including network design and reimbursement methods.

Provide ongoing compliance support and guidance to various internal stakeholders, fostering a culture of ethics and compliance throughout the organization.

What you will bring to SmithRx :

Education & Experience

Relevant bachelor's or advanced degree preferred

At least 8 years of experience in healthcare regulatory compliance or related fields

Technical Expertise

Strong foundation in healthcare laws and regulations affecting PBMs (e.g., HIPAA, PBM / TPA licensing, utilization review laws, pharmacy laws, ERISA regulations)

Experience interacting with government administrative agencies and regulators

Communication & Collaboration

Excellent written and oral communication skills

Ability to collaborate effectively with cross-functional teams and external stakeholders

Analytical & Solutions-Focused

Highly analytical and detail-oriented, able to interpret complex regulations and provide actionable guidance

Adept at navigating fast-paced, high-growth environments

Autonomous & Organized

Comfortable operating with a high degree of independence

Skilled at prioritizing tasks under pressure and communicating expectations clearly

Healthcare Passion

Genuine interest in improving access to affordable, convenient healthcare

Excited by the challenge of building a compliance function at a high-growth healthcare technology company

What SmithRx Offers You :

Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance and AD&D Insurance

Flexible Spending Benefits

401(k) Retirement Savings Program

Short-term and long-term disability

Discretionary Paid Time Off

12 Paid Holidays

Wellness Benefits

Commuter Benefits

Paid Parental Leave benefits

Employee Assistance Program (EAP)

Well-stocked kitchen in office locations

Professional development and training opportunities

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