Compliance Lead (Pharmacy)

Location: Remote nationwide in the United States; candidates near Louisville, Kentucky may have the option to work in a hybrid home/office arrangement. Occasional travel, including travel outside the state of residence, may be required. Working hours are Monday–Friday, 8:30am–5:00pm EST, with some flexibility.

Salary: $115,200–$158,400 per year, plus eligibility for a bonus incentive plan.

Company

hirify.global is a U.S. healthcare company providing insurance and healthcare services for Medicare, Medicaid, families, individuals, military personnel, and communities.

What you will do

• Develop and implement compliance policies and procedures for Medicare Parts B and D.
• Research regulatory and contractual requirements and translate them into actionable guidance for pharmacy business units and external partners.
• Conduct risk assessments, audits, monitoring activities, performance reviews, and remediation planning across pharmacy programs.
• Participate in CMS, state, and other regulator audits and coordinate corrective action plan implementation.
• Analyze regulatory documents and operational data to identify evidence of compliance, risks, and improvement opportunities.
• Collaborate with pharmacy operations, risk teams, regulatory compliance leadership, and other business stakeholders.

Requirements

• Bachelor’s degree.
• Five years of pharmacy experience in claims operations.
• Four or more years of experience in compliance, risk management, or managed care, including interpreting complex regulatory guidance.
• Experience with auditing, consulting, regulatory agencies, CMS, and state departments of health insurance.
• Knowledge of healthcare regulations and PBM operations.
• Strong communication, influence, stakeholder alignment, and guidance-translation skills in a highly matrixed environment.

Nice to have

• PharmD, Juris Doctorate, or master’s degree.
• Healthcare compliance certification such as CHC or CCEP.

Culture & Benefits

• Remote work with a potential hybrid option near Louisville, Kentucky.
• Medical, dental, and vision coverage.
• 401(k) retirement savings plan.
• Paid time off, company and personal holidays, and paid parental and caregiver leave.
• Short- and long-term disability coverage, life insurance, and wellness-focused benefits.
• Dedicated, interruption-free workspace and reliable home internet are required to protect PHI and HIPAA information.