Lead Director, PBM Corporate Compliance

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary:

As a Pharmacy Benefit Manager (PBM) Corporate Compliance Lead Director, you will serve as a key compliance leader responsible for overseeing regulatory adherence and governance across Caremark's PBM business. In this highly visible role, you will help ensure alignment with evolving state and federal PBM requirements while partnering closely with PBM Operations, Legal, Enterprise Compliance, and other cross-functional business partners.

As a strategic member of the Compliance leadership team, you will guide the integration of compliance obligations into the organization's operational, contractual, data, technology, and client-facing processes. You will provide leadership and oversight to promote continuous regulatory readiness, strengthen risk management practices, establish and maintain effective compliance controls, validate compliance through evidence-based reviews, and foster a proactive culture of compliance within a complex and rapidly evolving regulatory environment.

Success in this role requires a collaborative and influential leader who can build strong partnerships, develop high-performing teams, provide trusted guidance to stakeholders, drive alignment across diverse teams, and uphold the highest standards of regulatory integrity and operational excellence.

Key Responsibilities:

Lead regulatory compliance initiatives for Caremark's PBM business, including assessing new federal and state requirements; partnering with Legal to determine regulatory applicability and business impact; and driving implementation of compliance requirements across business operations, systems and controls.

Partner with Legal and cross-functional stakeholders to ensure compliance is embedded across business operations, processes, systems, and governance frameworks.

Drive implementation of regulatory requirements and compliance initiatives through completion, validating effectiveness through evidence of compliance and ensuring sustainable operational controls are established and maintained.

Oversee PBM-related compliance investigations, including issue assessments, root cause analysis, reporting, and executive updates, while ensuring effective corrective actions are implemented and sustained.

Represent Compliance on enterprise governance committees and key business initiatives.

Provide strategic compliance leadership, guidance to business partners, fostering a culture of compliance, 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.

Required Qualifications:

10+ years of combined experience in Compliance, Regulatory Affairs, Risk Management, Audit, Project Management or similar oversight disciplines

Strong background in leading major projects and mentoring project leaders

Ability to travel up to 10%-15% (including by plane)

Preferred Qualifications:

Deep expertise in PBM regulatory and operational domains, including:

PBM economics, manufacturer contracting, and rebate administrationPBM client onboarding and implementation lifecycle

Compliance with federal and state PBM regulatory requirements, including:

Rebate pass‑through requirements

Pricing transparency and detailed reporting mandates

Pharmacy reimbursement parity and benchmarking requirements

State‑level PBM reporting and audit obligations

Any‑Willing‑Pharmacy standards.

Contract compliance, ERISA‑related changes, and fiduciary requirements

Pharmacy complaint, dispute, and appeal processes

Demonstrated success leading large‑scale compliance and regulatory programs and operational readiness initiatives within PBM, healthcare, pharmacy, managed care, or other…