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Senior Pharmacy Compliance Program Manager - Billing and Reimbursement

Apply Job Req. ID 9817BR Date Posted 08/16/2019 Location Lakeland, Florida
Publix is currently seeking a Senior Pharmacy Compliance Program Manager for our Pharmacy Compliance Program for our Corporate Office in Lakeland, Florida. The Senior Pharmacy Compliance Program Manager will be responsible for the continued growth and development of the Pharmacy Compliance Program for our billing and reimbursement infrastructure. The successful candidate will have an intimate knowledge of pharmacy compliance, extensive experience in managing and developing pharmacy compliance programs, and expert familiarity managing third party payor relationships as well as understanding analytic capabilities to help identify future compliance concerns. Additional tasks include: managing talent, project management, and overseeing audits, risk assessments, remediation and monitoring efforts. This position is influential as Publix continues to expand our Pharmacy footprint. Publix currently operates over 1100 pharmacies across the Southeast, and this position will play a major role in helping our pharmacy division continue to grow and prosper successfully.
Required Qualifications
  • Bachelor of Pharmacy or Doctorate of Pharmacy degree
  • at least six (6) years’ experience independently managing pharmacy projects (i.e., serving as lead for improvement effort with defined deliverables/outcomes)
  • at least six (6) years’ experience working with pharmacy regulatory processes
  • at least six (6) years’ experience developing pharmacy billing process documentation and/or analyzing business processes
  • knowledge of project management techniques, strategic planning continuous quality improvement methodology
  • knowledge of Chapter Eight of the Federal Sentencing Guidelines and other similar rules relating to executing effective corporate pharmacy compliance programs
  • knowledge of communication types and vehicles, and the ability to communicate and negotiate effectively with all levels of the organization and third-party payors
  • ability to facilitate team development of mitigation strategies that protect Publix and support Publix’s overall strategic direction
  • strong independent judgment and diplomacy skills
  • strong risk assessment skills
  • advanced problem-solving skills
  • advance knowledge of Microsoft Office; Word, Excel, and SharePoint
  • intermediate knowledge of PowerPoint
  • willingness to travel
Preferred Qualifications
  • Doctorate degree in Pharmacy from an accredited university or equivalent work experience
  • eight (8) or more years’ experience independently managing large cross-functional pharmacy projects involving multiple business areas
  • eight (8) or more years management-level or decision-making experience working in pharmacy regulatory functions (e.g., audit, compliance, etc.)
  • eight (8) or more years’ experience developing pharmacy process documentation and/or analyzing business processes
  • Certified Compliance and Ethics Professional (CCEP)
  • Certified in HealthCare Compliance (CHC)
  • knowledge of regulations promulgated by various governmental agencies that impact pharmacy reimbursement and compliance programs
  • knowledge of Publix functions and processes associated with each business area within the company
  • knowledge of Corporate Compliance and Ethics Program methodology
  • knowledge of general audit principles
  • knowledge of structured writing techniques, including knowledge of MS Word templates and Publix-specific templates (such as BigDoc and SmallDoc)
Potential Annual Pay with Bonus 96,655 -144,950 Frequency of Pay Monthly Hours of Work Minimum 45 hours per week. Year End Bonus As a year-end bonus to associates, Publix issues one month’s extra pay (pro-rated in the first year) each year if associate remains employed through issue date of the bonus check that year. This is calculated as a 13th month of pay in the Potential Annual Pay with Bonus line above.

Address 3300 Publix Corporate Parkway City Lakeland Region FL between Orlando and Tampa Benefits ▪ Employee stock ownership plan that contributes Publix stock to associates each year at no cost
▪ An opportunity to purchase additional shares of our privately-held stock
▪ 401(k) retirement savings plan
▪ Group health plan (with prescription benefits)
▪ Group dental plan
▪ Group vision plan
▪ Sick pay
▪ Long-term disability insurance
▪ Company-paid life insurance (with accidental death & dismemberment benefits)
▪ Tuition reimbursement
▪ Vacation pay
▪ Free hot lunches (buffet-style) at facilities with a cafeteria
▪ Paycheck direct deposit
▪ Credit union
▪ Access to over 50 discount offers including discounts on computer, vehicle and wireless purchases
▪ 6 paid holidays (associates can exchange the following holidays with their manager’s approval: New Year’s Day, Memorial Day, Fourth of July, and Labor Day).

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