Job Information
McKesson Corporation Compliance Manager - Provider Solutions in Columbus, Ohio
McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you. The Compliance Manager will be responsible for ensuring that the business segments and products within the PSaS Provider Solutions organization, Medically Integrated Dispensing "MID" practices, are adhering to McKesson's compliance program that follows the seven elements of an effective compliance program as set out by the Office of Inspector General. The Compliance Manager will map business processes to build a compliance program to reduce regulatory risks and ensure effectiveness. These include implementing written policies, procedures, and a code of conduct, designating a compliance officer and compliance committee, conducting new hire and annual training, establishing our Integrity Line which encourages individuals to speak up if they have concerns, conducting internal monitoring and auditing, enforcement through disciplinary guidelines, and promptly responding to investigations and taking corrective actions. The Compliance Manager will build and monitor effectiveness of the compliance program as it is designed to prevent and detect misconduct, and that MID businesses are acting in compliance with applicable federal and state laws and regulations and McKesson's policies.The Compliance Manager is responsible for implementing contract and regulatory compliance procedures, assessing pharmacy compliance, identifying claim billing errors and remediating issues. The Compliance Manager assists in the development and enhancement of audit tools and processes to effectively identify erroneous claims, non-compliant pharmacy practices or potential pharmacy reimbursements. This role may also assist with other compliance activities under the PSaS Provider Solutions umbrella as needed or requested by compliance leadership. Reporting Structure: Reports to Sr. Director of Compliance & Ethics - Pharmacy Key Responsibilities Observe business practices and review documentation in accordance with McKesson compliance program. Conduct compliance risk assessments and assist with development of risk-based compliance workplans. Maximize current strengths of the compliance program, identify and remedy gaps, proactively assess and address emerging compliance risks. Drive and advance compliance monitoring activities. Develop appropriate analytics to analyze compliance to applicable regulations and internal policies. Analyze pharmacy claims and conduct claims reviews to ensure compliance with contractual and regulatory obligations. Identify opportunities to improve processes and drive efficiency and innovation; collaborate with practice & pharmacy staff, training, quality assurance, and department leadership to develop and implement new or enhanced practices. Adhere to completion turnaround times, quality metrics, and other performance indicators established within the business segment compliance program. Track audit and monitoring activities to support data analysis and reporting efforts within McKesson. Establish effective partnerships across Provider Solutions and enabling functions, such as Internal Audit, Human Resources, IT, Employee Relations, Legal, etc. Other duties as assigned Minimum Requirements 4+ years of related experience with at least 2 years pharmacy experience. Desired backgrounds should include healthcare provider compliance , pharmacy compliance, or pharmaceuticals co