VP, Risk & Pharmacy Compliance - Fuze Health at Fuze Health — NeverHard

Job Summary At Fuze Health, we put patients first and tirelessly address the most pressing needs in healthcare. We empower millions to digitally connect with care providers, essential health resources and needed treatments – and enable care providers, employers, health plans and life sciences companies to meaningfully enhance quality, outcomes and value. We are dedicated to helping our partners evolve and modernize to meet emerging patient and marketplace needs. The VP, Risk & Pharmacy Compliance will serve as the senior leader responsible for enterprise-wide pharmacy compliance, regulatory strategy, and risk management. This executive will partner closely with senior leadership, legal, operations, clinical, product, and technology teams to ensure Fuze Health maintains a best-in-class compliance program that supports growth while meeting all applicable federal and state regulatory requirements. This leader will provide strategic direction and oversight for pharmacy compliance operations across all 50 states, oversee regulatory interactions and investigations, lead enterprise risk assessments, and foster a culture of compliance throughout the organization. The VP will also be responsible for advancing compliance governance, strengthening regulatory readiness, and ensuring compliance considerations are integrated into business strategy, innovation initiatives, and emerging technologies, including AI-enabled solutions. The ideal candidate brings deep expertise in pharmacy and healthcare compliance, demonstrated experience leading large-scale compliance programs within highly regulated environments, and the ability to influence executive stakeholders while building and developing high-performing teams. Responsibilities Enterprise Compliance Leadership & Governance Establish and lead an enterprise-wide pharmacy compliance and risk management program aligned with organizational objectives and regulatory requirements. Serve as the senior compliance advisor to executive leadership on pharmacy regulatory matters, compliance risks, and emerging regulatory trends. Develop and execute a long-term compliance strategy that supports business growth while maintaining regulatory excellence. Promote a culture of ethics, integrity, accountability, and compliance across the organization. Regulatory Compliance & Oversight Provide strategic oversight of pharmacy compliance activities spanning all 50 states. Ensure compliance with applicable federal and state laws and regulations, including HIPAA, HITECH, Medicare Part D, Medicaid, state pharmacy regulations, and other healthcare regulatory requirements. Oversee pharmacy licensing, accreditation, certification, and regulatory reporting activities. Lead responses to regulatory audits, inspections, investigations, complaints, and inquiries from government agencies and pharmacy boards. Risk Management & Monitoring Direct enterprise pharmacy compliance risk assessments and develop risk mitigation strategies. Identify and proactively address areas of regulatory risk, including drug diversion, fraud, waste and abuse, privacy, data security, and operational compliance. Oversee compliance monitoring, auditing, and reporting programs to assess effectiveness and identify opportunities for improvement. Ensure timely implementation of corrective actions and remediation plans. Business Partnership & Strategic Enablement Partner with clinical, operations, product, technology, and legal teams to embed compliance requirements into business processes and product development. Advise leadership on regulatory implications associated with strategic initiatives, new products, partnerships, and expansion opportunities. Support the organization’s adoption of emerging technologies, including AI, by providing guidance on privacy, compliance, governance, and data security considerations. Collaborate cross‑functionally to ensure contractual, regulatory, and accreditation obligations are met. Team Leadership & Development Lead, mentor, and develop a high-performing compliance organization. Build scalable compliance processes, capabilities, and governance structures to support continued growth. Elevate the visibility and impact of the compliance function across the enterprise. Foster professional development and succession planning within the compliance team. Qualifications Minimum Qualifications Bachelor's degree required; advanced degree (JD, PharmD, MPH, MBA, or related field) preferred. 12+ years of progressive experience in healthcare compliance, pharmacy compliance, regulatory affairs, or risk management within a highly regulated healthcare environment. Significant leadership experience overseeing enterprise compliance programs and managing teams. Deep expertise in healthcare regulatory requirements, including HIPAA/HITECH, Medicare, Medicaid, OIG guidance, pharmacy regulations, accreditation standards, and privacy laws. Experience serving as a senior compliance leader, Compliance Officer, Head of Compliance, VP of Compliance, or similar role within a pharmacy, PBM, health plan, specialty pharmacy, or healthcare organization. Demonstrated experience managing regulatory audits, investigations, licensing, accreditation, and enterprise risk management initiatives. Prior experience within a Pharmacy Benefit Manager (PBM), specialty pharmacy, health plan, or large pharmacy organization. Preferred Qualifications Experience interacting directly with executive leadership, boards, regulators, and accrediting bodies. Familiarity with regulatory intelligence tools and compliance management systems. Experience advising organizations on compliance implications of digital health, AI, privacy, and data governance initiatives. CIPP, CHC, CHPC, or similar compliance/privacy certification preferred. Physical Requirements Ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time, stoop, bend, and reach for equipment and supplies, make frequent repetitive motions required to operate a computer that include the wrists, hands and fingers, and lift, carry, push, pull, and move light objects up to 20 pounds. The role also requires the ability to effectively communicate through verbal interactions, discern auditory information, and visually perceive details to perform essential job functions. Compensation Salary Range: $240,000-$270,000 Commission Eligible: No Equity Eligible: Yes Travel: Yes - Required up to 20% of the time Location Limited to individuals residing in the following states: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Vermont, Virginia, Washington (WA), Wisconsin. Benefits Dental, vision, and multiple group medical plans to choose from. 401(k) retirement savings plan. Group life insurance. Accidental death and dismemberment (AD&D) insurance. Flexible spending account (FSA) and health savings account (HSA). Commuter benefits. Employer-paid short-term (STD) and long-term disability (LTD) insurance. Additional supplemental insurance plans (spouse life insurance, legal insurance, an employee assistance program, home health testing kits, and a fertility medication discount program). Flexible vacation time, accrued paid sick time, 10 paid holidays (2 floating holidays for full-time non-exempt employees). Eight weeks of paid parental leave for eligible employees, additional paid weeks for the birthing parent, 4 weeks paid caregiver leave, and a Lifestyle Spending Account allowance each month. Equal Opportunity Employer Fuze Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, gender identity, sexual orientation, age, disability, veteran status, or any other legally protected basis. If you have a disability and require reasonable accommodation during any portion of the application or hiring process, please contact us at talent@fuzehealth.com. Fuze Health considers qualified applicants with arrest or conviction records for employment and conducts background checks consistent with applicable law, including the California, Los Angeles County, San Francisco, Philadelphia, and New York City Fair Chance laws. We are an E‑Verify participating company. Use of Automated Decision Tools: Fuze Health recruiters and hiring managers may use automated decision tools to help identify candidates who match the stated job requirements, and to what extent. These tools are designed to help ensure fairness in all aspects of the hiring process by providing recruiters and hiring managers with data-backed insights based on information provided in your resume, including work experience, education, and other skills. Fuze Health does not use automated decision tools to make hiring decisions; hiring decisions always involve human review and input. If you have any questions or would like to request an alternative process, please contact us at talent@fuzehealth.com. Privacy Notice: To learn about Fuze Health’s privacy practices, including compliance with applicable privacy laws, please read our Privacy Notice for Job Applicants. #J-18808-Ljbffr