Full-Time

Lead Director

PBM Corporate Compliance

Posted on 9/11/2026

Deadline 9/30/26
CVS Health

CVS Health

10,001+ employees

Healthcare, insurance, PBM, and retail pharmacy

Compensation Overview

$100k - $231.5k/yr

+ Bonus + Commission + Short-term incentive + Equity award

Company Historically Provides H1B Sponsorship

Scottsdale, AZ, USA + 2 more

More locations: Minneapolis, MN, USA | Woonsocket, RI, USA

Hybrid

Remote/hybrid work is available; travel up to 10%-15% is required.

Bachelor's, MBA, JD

Category
Risk & Compliance (1)
Required Skills
Risk Management

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Requirements
  • At least 10 years of combined experience in Compliance, Regulatory Affairs, Risk Management, Audit, Project Management, or similar oversight disciplines.
  • A strong background in leading major projects and mentoring project leaders.
  • Ability to travel up to 10%-15%, including by plane.
  • A Bachelor's Degree is required, although equivalent years of related professional work experience may substitute.
Responsibilities
  • Lead regulatory compliance initiatives for Caremark’s Pharmacy Benefit Manager business, including assessing new federal and state requirements, partnering with Legal to determine regulatory applicability and business impact, and driving implementation across business operations, systems, and controls.
  • Partner with Legal and cross-functional stakeholders to embed compliance across business operations, processes, systems, and governance frameworks.
  • Drive regulatory requirements and compliance initiatives through completion, validate effectiveness through evidence of compliance, and establish and maintain sustainable operational controls.
  • Oversee Pharmacy Benefit Manager-related compliance investigations, including issue assessments, root cause analysis, reporting, and executive updates, while ensuring corrective actions are implemented and sustained.
  • Represent Compliance on enterprise governance committees and key business initiatives.
  • Provide strategic compliance leadership and guidance to business partners while fostering regulatory accountability and operational excellence.
  • Lead, mentor, and develop a team of compliance professionals and people leaders through coaching, performance management, succession planning, and talent development.
Desired Qualifications
  • Deep expertise in Pharmacy Benefit Manager regulatory and operational domains, including Pharmacy Benefit Manager economics, manufacturer contracting, and rebate administration.
  • Experience with Pharmacy Benefit Manager client onboarding and implementation lifecycles.
  • Knowledge of federal and state Pharmacy Benefit Manager regulatory requirements, including rebate pass-through requirements, pricing transparency and detailed reporting mandates, pharmacy reimbursement parity and benchmarking requirements, state-level Pharmacy Benefit Manager reporting and audit obligations, Any-Willing-Pharmacy standards, contract compliance, ERISA-related changes, fiduciary requirements, and pharmacy complaint, dispute, and appeal processes.
  • Demonstrated success leading large-scale compliance and regulatory programs and operational readiness initiatives within Pharmacy Benefit Manager, healthcare, pharmacy, managed care, or other highly regulated industries.
  • Exceptional communication, executive-level presentation, and stakeholder-management skills.
  • Proven success leading and developing teams, including mentoring leaders and building organizational capability.
  • An advanced degree, such as a JD, MBA, MPH, or related degree.

CVS Health operates as a diversified health services company in the United States, organized into Health Care Benefits, Pharmacy & Consumer Wellness, and Health Services. Its offerings include medical insurance products, retail and mail-order prescription drugs, and pharmacy benefit management (PBM) services, all connected through its integrated platform. By combining insurance, retail pharmacy, PBM, and health solutions, CVS Health coordinates care and controls costs across touchpoints for individuals, employers, and government programs. The company aims to lower health care costs while improving access and health outcomes for customers.

Company Size

10,001+

Company Stage

IPO

Headquarters

Woonsocket, Rhode Island

Founded

1963

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Simplify Jobs

Simplify's Take

What believers are saying

  • CVS raised 2026 adjusted EPS guidance to $7.90-$8.10 on August 5, 2026.
  • CVS Caremark settled FTC probes July 14, 2026, reducing legal overhang.
  • CVS expanded Eli Lilly weight-loss access in early fourth quarter 2026.

What critics are saying

  • Louisiana's February 2026 $45 million settlement keeps PBM reform pressure on Caremark margins.
  • Aetna paid $117.7 million on March 11, 2026 for Medicare coding fraud allegations.
  • Federal and state antitrust actions threaten a Caremark-Aetna breakup by 2027.

What makes CVS Health unique

  • CVS integrates Aetna, Caremark, and 9,000 pharmacies across 87 million PBM members.
  • CVS combines retail, insurance, and PBM data under one operating system.
  • CVS launched Google Cloud partnerships and AI tools across claims, service, and engagement.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Company News

Yahoo Finance
Aug 28th, 2026
CVS stock down 12% in a month despite 34% annual gain, faces 2027 headwinds

CVS Health stock has declined 12.3% over the past month, sitting about 15% below its 52-week high, though it remains up 34% over the trailing twelve months. The company's revenue reached approximately $415 billion, up 7.4% year-over-year. Management raised its full-year 2026 adjusted earnings per share guidance by $0.60 to a range of $7.90 to $8.10. For 2027, the company anticipates membership declines at Caremark and continued 340B programme pressure, offset by Aetna's recovery, which added over $2 billion in adjusted operating income in the first half of 2026. Management considers a 2027 adjusted EPS outlook of at least $8.44 reasonable. Historically, CVS has experienced varied recovery periods following market downturns, with some rebounds taking years rather than months.

Yahoo Finance
Aug 25th, 2026
CVS and Roche stocks could benefit from expanding GLP-1 drug market

CVS Health and Roche could benefit from the growing GLP-1 drug market, alongside current leaders Eli Lilly and Novo Nordisk. CVS Health has improved its financial performance, with second-quarter revenue rising 7.3% year-over-year to $106.1 billion and adjusted earnings per share increasing 42.5% to $2.58. The pharmacy chain offers all approved GLP-1 medicines in the US, including Eli Lilly's Zepbound and Foundayo, plus Novo Nordisk's Wegovy. CVS also provides low-cost online consultations at $29 to assess patient eligibility for GLP-1 drugs. Beyond GLP-1 initiatives, CVS is addressing previous business challenges and is positioned to capitalise on rising healthcare spending in the US over the next decade.

Yahoo Finance
Aug 19th, 2026
CVS Health appoints JPMorgan data executive to board as focus shifts to digital healthcare

CVS Health has appointed Teresa Heitsenrether, a senior executive from JPMorgan Chase with extensive data and analytics experience, to its board of directors. The move follows the resignation of board member Larry M. Robbins. The appointment signals CVS Health's focus on technology and data-driven healthcare at the governance level. The company, valued at approximately $120bn, operates an integrated healthcare model spanning insurance, pharmacy benefits, and retail services. Heitsenrether's data expertise aligns with CVS Health's strategy to leverage digital capabilities and operational efficiency across its businesses, including Aetna and Caremark. The company faces challenges including high debt levels and reimbursement pressures in a competitive market alongside UnitedHealth Group and Cigna.

Yahoo Finance
Aug 14th, 2026
CVS Health beats Q2 revenue and profit estimates but faces questions on sustainability

CVS Health reported second quarter revenue of $106.1 billion, beating analyst estimates of $99.41 billion by 6.7%. Adjusted earnings per share came in at $2.58, surpassing expectations of $1.85 by 39.4%. Management attributed strong performance to specialty pharmacy and Medicare Advantage, with CEO David Joyner noting improvements from actions taken in Aetna and Caremark. The company raised its full-year adjusted EPS guidance to $8 at the midpoint. However, analysts raised concerns about sustainability. Management acknowledged ongoing challenges in the 340B program and normalisation of script share gains from Rite Aid. To offset these headwinds, executives pointed to biosimilars and investments in service technology. The company has committed $20 billion over a decade to AI and technology investments, with operational savings already being realised.

Fox Business
Aug 13th, 2026
Nine major PBMs to display TrumpRx prescription drug prices from 2027

Nine pharmacy benefit managers will integrate TrumpRx prescription drug pricing into their benefit tools, effective 1 January 2027. The Pharmaceutical Care Management Association and participating PBMs—including CVS Health, Express Scripts, Humana, and OptumRx—will display cash prices from TrumpRx alongside plan coverage costs. The agreement covers commercial, Medicare, and Medicaid plans. Patients will see TrumpRx prices for all listed drugs, whether through presidential deals or standard pricing. CMS Administrator Dr Mehmet Oz said the commitment will help patients compare prices and find better deals. PCMA CEO David Marin stated the transparency will allow consumers to make better-informed choices about prescription drug costs. Some PBMs will use Real Time Benefit Tools to display pricing comparisons, whilst others may employ different methods.