Senior Director, Compliance and Internal Audit (Healthcare & Pharmacy)

Polaris Pharmacy Services•Fort Lauderdale, FL

14d•Onsite

About The Position

The Senior Director of Compliance and Internal Audit leads the organization's enterprise risk management, healthcare regulatory adherence, and clinical/financial internal controls. This role designs risk-based audit plans, drives compliance with federal and state healthcare laws, and oversees corporate governance. The position reports directly to the General Counsel, serving as a critical advisor on mitigating regulatory, operational, and financial risks.

Requirements

Bachelor’s in Healthcare Administration, or related field preferred
Active CPA or CIA required
7 to 15 years in healthcare internal audit, corporate compliance, or hospital/pharmacy risk management.
Direct experience with CMS reimbursement models, pharmacy operations, or healthcare consulting.
Deep knowledge of Stark Law, Anti-Kickback Statute (AKS), False Claims Act, and HIPAA.
Proficiency in electronic health record (EHR) systems, pharmacy management software, and data analytics tools.
Executive presence with the ability to communicate complex regulatory findings to non-technical stakeholders.

Nice To Haves

CHC, CHPC, or CHRC preferred

Responsibilities

Lead the corporate compliance program to ensure alignment with OIG, HHS, CMS, and FDA regulations.
Oversee HIPAA privacy and security controls to safeguard Protected Health Information (PHI).
Monitor pharmacy operations for compliance with DEA regulations and the Drug Supply Chain Security Act (DSCSA).
Manage fraud, waste, and abuse (FWA) prevention, detection, and investigation programs.
Develop and execute a comprehensive, risk-based annual healthcare audit plan.
Conduct clinical, operational, and financial risk assessments across all facilities and pharmacies.
Oversee specialized audits covering pharmacy billing, 340B programs, and clinical documentation.
Oversee Internal Controls over Financial Reporting (ICFR).
Integrate healthcare compliance risks into the enterprise COSO framework.
Lead billing compliance audits, including Medicare, Medicaid, and commercial payer claims.
Present audit findings and regulatory risk profiles directly to the Compliance Committee and beyond.
Deliver root-cause analyses and corrective/preventive action (CAPA) plans to the Board.
Serve as the primary liaison for external regulatory audits and government inquiries.
Partner with Clinical Operations, Pharmacy Directors, Legal, Finance, and IT Security.
Mitigate systemic risks associated with medical billing, credentialing, and drug dispensing.
Drive continuous process improvements to enhance patient safety and operational efficiency.
Mentor, recruit, and develop a specialized team of healthcare auditors and compliance staff.
Manage the department's annual budget and coordinate third-party healthcare consulting vendors.
Foster an organizational culture of strict ethical standards, compliance, and accountability.