Director, PBM Compliance and Regulatory Affairs

ABOUT THE ROLE: We are seeking an articulate, thorough and highly organized individual who is results driven with a passion for risk mitigation. The Director of PBM Compliance and Regulatory Affairs will be a critical leader of Rightway’s Compliance team. As a strategic member of the team, you will guide the integration of compliance obligations into the organization’s operational, contractual, data, technology, and client-facing processes. You will provide leadership and oversight to promote continuous regulatory readiness, strengthen risk management practices, establish and maintain effective compliance controls, validate compliance through evidence-based reviews, and foster a proactive culture of compliance within a complex and rapidly evolving regulatory environment. This role is instrumental in establishing a best in class compliance department and have the tactical skills to execute on the departmental needs through system integration, policy establishment and results monitoring. WHAT YOU’LL DO: - Perform federal and state regulatory research proactively anticipate business needs and requirements, identify and communicate potential risks/needs to key stakeholders, develop policies and procedures as well as strategic plans to mitigate risks and address needs - Specific to business registration and licensure requirements, routinely conduct and monitor state and federal regulations, in addition, prepare, file and manage business registrations and licenses including the submission of required reporting - Partner with department leads to ensure compliance with all statutory and regulatory requirements, pharmacy compliance activities and PBM compliance initiatives across the business; develop and maintain department approved regulatory and legislative compliance plan; create, implement, and maintain effective internal controls including policies and procedures - Partner with department leads to ensure terms and conditions within vendor and client contracts as well as other pertinent agreements comply with applicable state and federal regulations - Track, monitor and communicate across departments i) policies and procedures; ii) performance and reporting requirements; and iii) key metrics - Participate as compliance subject matter expert on all mandated projects and escalated matters; achieve business operational compliance with all related measures relative to PBM accreditation initiatives - Maintain an understanding and knowledge of regulatory affairs in all applicable jurisdictions and regulatory environments; lead and facilitate the development of company positions as well as internal and external responses related to pending regulatory initiatives - Develop and implement training and communication plans; manage and lead scheduled and ad-hoc compliance projects; provide and deliver compliance consultation services to all departments - Provide strategic compliance leadership and guidance to Rightway clients and business partners, fostering a culture of compliance, regulatory accountability, and operational excellence. - Promote continuous improvement of regulatory programs and initiatives by identifying opportunities for improvement; work with key stakeholders across departments to design and implement regulatory process improvement programs and initiatives; and develop recommendations - Conduct, direct, lead and facilitate all activities related to Internal and External (Regulatory and Client) audits and responses to findings - Lead, mentor, and develop a team of compliance professionals and people leaders through coaching,performance management, succession planning, and talent development. WHO YOU ARE: - Education level: Bachelor’s Degree Required (Preferred: Master’s Degree) and JD (Juris Doctorate) degree or equivalent combination of practical experience - Work experience: Minimum 7 years of relevant work experience in the healthcare industry with PBM industry experience preferred - Important characteristics of ideal candidate: Detail-oriented, analytical, intellectually curious, good listener, empathetic, ability to challenge status quo, values exemplar - Specific skills needed for job: Solid communication, research and organizational skills, ability to lead projects and influence others even without direct reporting line ownership - Ability to work independently and manage multiple projects in a fast-paced, fluid environment - Advanced computer and Windows skills required COMPENSATION: $185,000 - $220,000 annually, in addition to bonus and equity Compensation offered will be determined by geographic location, experience, and qualifications. CYBERSECURITY AWARENESS NOTICE In response to ongoing and industry-wide fraudulent recruitment activities (i.e., job scams), Rightway wants to inform potential candidates that we will only contact them from the @rightwayhealthcare.com email domain. We will never ask for bank details or deposits of any kind as a condition of employment. ABOUT RIGHTWAY: Rightway is on a mission to harmonize healthcare for everyone, everywhere. Our products guide patients to the best care and medications by inserting clinicians and pharmacists into a patient’s care journey through a modern, mobile app. Rightway is a front door to healthcare, giving patients the tools they need along with on-demand access to Rightway health guides, human experts that answer their questions and manage the frustrating parts of healthcare for them. Since its founding in 2017, Rightway has raised over $300mm from investors including Khosla Ventures, Thrive Capital, Francisco Partners, and Tiger Global. We’re headquartered in New York City, with satellite offices in Denver and Dallas. Our clients rely on us to transform the healthcare experience, improve outcomes for their teams, and decrease their healthcare costs. HOW WE LIVE OUR VALUES TO OUR TEAMMATES: We’re seeking those with passion for healthcare and relentless devotion to our goal. We need team members that embody our core values: 1) We are human, first Our humanity binds us together. We bring the same empathetic approach to every individual we engage with, whether it be our members, our clients, or each other. We are all worthy of respect and understanding and we engage in our interactions with care and intention. We honor our stories. We listen to—and hear—each other, we celebrate our differences and similarities, we are present for each other, and we strive for mutual understanding. 2) We redefine what is possible We always look beyond the obstacles in front of us to imagine new solutions. We approach our work with inspiration from other industries, other leaders, and other challenges. We use ingenuity and resourcefulness when faced with tough problems. 3) We debate then commit We believe that a spirit of open discourse is part of a healthy culture. We understand and appreciate different perspectives and we challenge our assumptions. When working toward a decision or a new solution, we actively listen to one another, approach it with a “yes, and” mentality, and assume positive intent. Once a decision is made, we align and champion it as one team. 4) We cultivate grit Changing healthcare doesn’t happen overnight. We reflect and learn from challenges and approach the future with a determination to strive for better. In the face of daunting situations, we value persistence. We embrace failure as a stepping stone to future success. On this journey, we seek to act with guts, resilience, initiative, and tenacity. 5) We seek to delight Healthcare is complicated and personal. We work tirelessly to meet the goals of our clients while also delivering the best experience to our members. We recognize that no matter the role or team, we each play a crucial part in our members’ care and take that responsibility seriously. When faced with an obstacle, we are kind, respectful, and solution-oriented in our approach. We hold ourselves accountable to our clients and our members’ success. Rightway is proud to be an Equal Opportunity Employer that believes in the strength of diverse thought, beliefs, backgrounds, and education. We foster an inclusive culture where differences are celebrated to drive the best business decisions possible. We do not discriminate on any basis protected by applicable law. All employment decisions are based on merit, qualifications, need, and performance.