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Chief Compliance Officer Resume Example

Resume Score: 70%

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CHIEF COMPLIANCE OFFICER
Executive Summary

Accomplished compliance executive with 25+ years' experience driving regulatory compliance and operations within the healthcare industry. Expertise in developing organizational policies and programs to meet ever changing federal and state government regulations including Board of Pharmacy, Medicare, Medicaid, and other third-party regulators. Cultivate strong business relationships with organizational leaders to align with key business supporters. Lead diverse teams to achieve organizational goals while communicating progress to board of directors.

Skill Highlights
  • Policy/program development
  • Medicare/Medicaid & HIPAA compliance
  • Expertise in Joint Commission Accreditation
  • Internal/government audit preparation
  • FDA drug safety guidelines
  • Strategic planning
  • Process improvements
  • Board of director presentations
Accomplishments
  • Implemented Corporate Integrity Agreements to comply with government-mandated regulations for entire 5 year agreement.
  • Investigated any violations of compliance policy, summarizing investigative findings to senior leadership and identifying the best corrective actions to report to government agencies or other appropriate stack holder.
  • Provided ongoing work plans and comprehensive compliance reports to the board of directors' audit committee within the regulatory environment in which the organization operated
  • Led an audit response team for significant Medicare and Medicaid audits.
Professional Experience
Chief Compliance Officer
June 2010 to January 2013
Company Name - City, State

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.
V.P. Clinical Operations and Operations Support
May 2002 to May 2006
Company Name - City, State

A specialty pharmacy and related services company for patients with certain complex and chronic conditions with $1.7 billion in annual revenue. 

  • Spearheaded clinical and operational policies and procedures of Accredo Therapeutics, a specialty pharmacy company with more than 40 branch locations nationwide.
  • Launched new specialty drugs available for limited distribution for home care therapy as well as revisions to clinical operations in collaboration with product management.
  • Oversaw centralized distribution for drug and specialty programs.

Director of Clinical Operations (05/2002-09/2003) 

  • Oversaw clinical protocols and training for specialty drug therapies including licensure requirements for states to obtain Joint Commission accreditation.
  • Established a culture for clinical excellence for company pharmacies and associated nursing programs.
Southeast Region Pharmacy Operations Specialist
October 1999 to May 2002
Company Name - City, State
General Manager
April 1998 to June 1999
Company Name - City, State
General Manager
May 1997 to April 1998
Company Name - City, State
President
May 1988 to May 1997
Company Name - City, State
Education
Masters level Certificate : Health Care Compliance, 2008George Washington University - City, State
  • One-year intensive program focused on regulatory compliance for healthcare providers and institutions.
Doctor of Pharmacy (Pharm.D.) : Clinical Pharmacy, 1980Mercer University - City, State
Bachelor of Science : Pharmacy, 1975University of Georgia - City, State
Affiliations

Healthcare Compliance Association

Society of Corporate Compliance and Ethics

Certifications

CHC - Certified in Healthcare Compliance.

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Resume Overview

School Attended

  • George Washington University
  • Mercer University
  • University of Georgia

Job Titles Held:

  • Chief Compliance Officer
  • V.P. Clinical Operations and Operations Support
  • Southeast Region Pharmacy Operations Specialist
  • General Manager
  • President

Degrees

  • Masters level Certificate : Health Care Compliance , 2008
    Doctor of Pharmacy (Pharm.D.) : Clinical Pharmacy , 1980
    Bachelor of Science : Pharmacy , 1975

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