Vice President, PBM Compliance, Regulatory Operations

Liviniti

Vice President of Compliance overseeing PBM regulatory and privacy operations at Liviniti. Building a compliance program and ensuring adherence to regulations while leading a team.

Posted 5/9/2026full-timeRemote • Illinois • 🇺🇸 United StatesLeadWebsite

About the role

Key responsibilities & impact

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

What you’ll need

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

Comp & perks

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

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

regulatory inventory managementcompliance controlsautomated editsclaims adjudicationMAC pricingpharmacy network standardsinternal readiness reviewsmock examsrisk assessmenthealthcare compliance

Soft Skills

professional ethicsintegritysound judgmentanalytical skillscross-functional collaborationleadershipcommunicationproblem-solvingteam buildingexecutive reporting

Certifications

Bachelor's degreeJuris Doctor (JD)Healthcare Administration certificationBusiness Administration certificationPublic Health certificationPharmacy certification