Director Ethics and Compliance

Date:
Jan 30, 2026

Location:

Any city, TX, US, 99999

Work Mode:
Virtual (Exception only)

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

Serving as the Account Compliance Officer, this individual will develop and manage the designated account compliance program and act as client point of contact for compliance issues related to large healthcare and/or pharmacy benefit manager client account(s). This position will have responsibility for the compliance program requirements for the assigned account, including investigation and audit activities. Responsibilities include attending meetings with all levels of client management, reporting status of compliance improvements and investigations, leading compliance projects and programs, leading and/or performing fraud, waste, and abuse investigations, facilitating compliance reviews, and overseeing all account compliance-related activities.

In addition, this position will have responsibility to manage the investigative team which includes a manager and investigators. This position will have a responsibility to ensure timely submissions of monthly, quarterly, and annual reports, requests for deconflictions, and referrals of investigation cases to the client. This position is an integral part of the Gainwell pharmacy compliance program and fraud, waste, and abuse program.

The clients that will be supported by this position are highly regulated with comprehensive compliance needs in accordance with state and federal laws and regulations related to healthcare, pharmaceutical, and/or pharmacy benefit manager program requirements. This position will implement account-specific compliance programs, including development of Corporate Compliance policy addenda to incorporate additional requirements into the Corporate Compliance policies and procedures library, quality improvement projects, risk assessment activities, and staff member training.

This position is required to act as a single point of contact for account compliance program management, and to provide compliance, audit, and regulatory-related subject matter expertise.

• Develop and administer account compliance program and risk assessments.
• Develop and update account-specific compliance addenda to corporate policies, procedures, guidance, and training for employees.
• Monitor and provide updates regarding federal and state regulations related to account compliance program, including healthcare, pharmaceutical, and/or pharmacy benefit manager requirements.
• Monitor and assess staff member compliance with policies, procedures, and laws and regulations.
• Develop, oversee, and provide reports regarding account compliance program, including compliance activities, risk assessments, audits, and compliance with regulatory and contractual requirements.
• Develop preventative and corrective strategies and action plans, as needed, to support the account compliance program, risk assessments, and contractual and regulatory requirements.
• Maintain documentation supporting the Corporate and/or account compliance program, including compliance policies and procedures, manuals, risk management plan, fraud, waste, and abuse plan, etc.
• Communicate with leadership and client regarding account compliance program, activities, risk assessments, audits, etc.
• Lead internal and external compliance-related discussions, presentations, and activities.
• Assist with audits by clients and government agencies.
• Conduct or assist with investigations, as needed.

• 7+ years of experience in corporate healthcare, pharmaceutical, and/or pharmacy benefit manager compliance and ethics experience is required. State or federal agency experience highly desired.
• Graduate or post-graduate degrees in law and/or experience in the pharmaceutical and compliance industries is required.
• Cert…