Vice President, PBM Compliance, Regulatory Operations

🕒 May 9

🌽 Illinois – Remote

🌽 Illinois – Remote

⏰ Full Time

🔴 Lead

🚔 Compliance

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Liviniti

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2011

⚕️ Healthcare Insurance

💊 Pharmaceuticals

🤝 B2B

Healthcare Insurance • Pharmaceuticals • B2B

Liviniti is a pass-through pharmacy benefit manager (PBM) that helps employers and health systems reduce prescription drug costs through transparent pricing, clinical programs, and drug sourcing. The company offers 100% rebate pass-through, a flat administrative fee, access to claims and rebate details for full visibility, customizable formularies and networks, prior authorization focused on lowest net cost, and specialized solutions like LivLite for managing GLP‑1 weight-loss drugs. Liviniti emphasizes B2B service, clinical value, and continuous innovation to lower pharmacy spend while maintaining member support and service.

📋 Description

• Build and Implement the Compliance Function • Own and maintain a state-by-state regulatory inventory and monitoring process • Partner with operations and technology to implement requirements in areas such as claims adjudication, MAC pricing, pharmacy network standards, and appeals processes • Build and maintain a continuous state of market conduct exam readiness • Conduct internal readiness reviews and mock exams • Design and implement system-based compliance controls and automated edits within PBM platforms • Oversee PBM responsibilities under the Consolidated Appropriations Act (CAA) • Provide executive leadership for the organization’s HIPAA Privacy, Security, and Breach Notification compliance programs • Serve as executive lead for HIPAA-related incidents, overseeing intake, investigation, risk assessment, and breach determination • Operate as a hands-on leader, directly owning key deliverables in early stages • Build and scale the compliance team over time • Provide regular reporting and insight to executive leadership

🎯 Requirements

• Bachelor's degree (B.A.) in Law, Healthcare Administration, Business Administration, Public Health, Pharmacy, or a related field, or 2+ years of related experience and/or training; or equivalent combination of education and experience • High degree of professional ethics and integrity • Sound judgment and ability to analyze situations and information • Juris Doctor (JD) or equivalent legal background strongly preferred • 10+ years of experience in healthcare compliance, PBM, health plan, or similar regulated environment • Demonstrated experience implementing regulatory requirements into operations, systems, or workflows • Strong knowledge of state PBM laws or comparable multi-state regulatory frameworks • Experience supporting market conduct exams, audits, or regulatory reviews • Proven ability to work cross-functionally with technology, operations, legal, and finance teams

🏖️ Benefits

• Medical, Dental, Vision insurance • Disability and Life insurance • Employee Assistance Program • Remote work options • Generous Paid-Time Off • Annual Reviews and Development Plans • Retirement Plan with company match immediately 100% vested