Compliance Manager - Provider Solutions

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The Compliance Manager will be responsible for ensuring that the business segments and products within the PSaS Provider Solutions organization, Medically Integrated Dispensing “MID” practices, are adhering to McKesson’s compliance program that follows the seven elements of an effective compliance program as set out by the Office of Inspector General. The Compliance Manager will map business processes to build a compliance program to reduce regulatory risks and ensure effectiveness. These include implementing written policies, procedures, and a code of conduct, designating a compliance officer and compliance committee, conducting new hire and annual training, establishing our Integrity Line which encourages individuals to speak up if they have concerns, conducting internal monitoring and auditing, enforcement through disciplinary guidelines, and promptly responding to investigations and taking corrective actions. The Compliance Manager will build and monitor effectiveness of the compliance program as it is designed to prevent and detect misconduct, and that MID businesses are acting in compliance with applicable federal and state laws and regulations and McKesson’s policies. The Compliance Manager is responsible for implementing contract and regulatory compliance procedures, assessing pharmacy compliance, identifying claim billing errors and remediating issues. The Compliance Manager assists in the development and enhancement of audit tools and processes to effectively identify erroneous claims, non-compliant pharmacy practices or potential pharmacy reimbursements. This role may also assist with other compliance activities under the PSaS Provider Solutions umbrella as needed or requested by compliance leadership.

Reporting Structure:

Reports to Sr. Director of Compliance & Ethics - Pharmacy

Key Responsibilities

Observe business practices and review documentation in accordance with McKesson compliance program. Conduct compliance risk assessments and assist with development of risk-based compliance workplans. Maximize current strengths of the compliance program, identify and remedy gaps, proactively assess and address emerging compliance risks. Drive and advance compliance monitoring activities. Develop appropriate analytics to analyze compliance to applicable regulations and internal policies. Analyze pharmacy claims and conduct claims reviews to ensure compliance with contractual and regulatory obligations. Identify opportunities to improve processes and drive efficiency and innovation; collaborate with practice & pharmacy staff, training, quality assurance, and department leadership to develop and implement new or enhanced practices. Adhere to completion turnaround times, quality metrics, and other performance indicators established within the business segment compliance program. Track audit and monitoring activities to support data analysis and reporting efforts within McKesson. Establish effective partnerships across Provider Solutions and enabling functions, such as Internal Audit, Human Resources, IT, Employee Relations, Legal, etc. Other duties as assigned

Minimum Requirements

4+ years of related experience with at least 2 years pharmacy experience. Desired backgrounds should include healthcare provider compliance , pharmacy compliance, or pharmaceuticals compliance .

Critical Skills

• In-depth knowledge understanding of healthcare compliance programs focused on pharmacy and/or practice compliance

• Possess working knowledge of Federal and State governmental regulations pertaining to compliance program requirements

• Excellent communication, collaboration, and influencing skills at all levels of the organization.

Additional Knowledge & Skills

• Proficiency in MS Word, Excel, and database software

• Excellent oral, written and interpersonal communication skills

• Self-directed worker with excellent organization and analytical skills

• Ability to work effectively with a variety of audiences at all levels of the organization

• Ability to maintain confidentiality of highly sensitive information

Education
4-year degree or equivalent experience.

Travel

• 15% travel to multiple business locations

Must be authorized to work in the US. Sponsorship is not available for this position.

We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here.

Our Base Pay Range for this position

$77,200 - $128,600

McKesson is an Equal Opportunity Employer

McKesson provides equal employment opportunities to applicants and employees and is committed to a diverse and inclusive environment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age or genetic information. For additional information on McKesson’s full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page.

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