Chief Compliance Officer Resume Example

Express Scripts is a pharmacy benefit management healthcare company serving the needs of more than 65 million people with active membership in S&P 500 and annual revenues exceeding $70 billion. 

• Directed organization-wide compliance initiatives impacting the specialty pharmacy or medical supplies business by managing more than 50 staff as well as a $3 million budget.
• Coordinate and manage the compliance effort for specialty pharmacy services and diabetes care for private and public employers, health plans, government agencies, and individuals served by Medicare Part D prescription drug plans.
• Drive preparation for government and regulatory audits, ensuring operational standards meet current industry guidelines for Accredo Health and Liberty Medical as well as the Medco / Express Scripts corporate program.
• Developed and updated policies and staff training initiatives to stay within changing Medicaid regulations, such as Deficit Reduction Act of 2005.
• Oversaw billing processes and implemented strategic process improvements to streamline operations.
• Partner with HR, legal, internal audit and pharmacy regulatory teams to become fluent in various state board licensing requirements.
• Educated organizations and established monitoring plans to prove compliance within all areas of fraud, waste, and abuse regulations.
• Developed annual budget and work plans to accomplish organizational compliance.
• Performed annual risk assessment and review to develop focus of on-going work plan and proper priorities.
• Ensure accuracy of compliance documentation by leading writing and editing initiatives from a team creating compliance policy and procedure manuals.
• Implemented enhancements to system documentation for greater accuracy and data analytics enhancements.
• Conducted monthly communications calls to educate all organizational pharmacists, nurses, and general managers about regulatory matters.
• Drove support for third-party reviews by developing third-party relationships and agreements; provided pharmacy regulatory guidance to ensure overall compliance within pharmacy operations.