Director Compliance (PBM Commercial & Exchange) - Remote

Eden Prairie, Minnesota (United States) Overview In this role you will own operational regulatory compliance for OptumRx PBM Commercial and Exchange across all 50 states. You will lead cross-functional efforts to embed regulatory controls, ensure readiness for complex state implementations, and manage regulator-facing escalations. Your work enables scalable, compliant solutions and reduces regulatory risk during launches. This role offers impact across markets, with a focus on transparency, evidence readiness, and continuous improvement. Compensation / Benefits comprehensive benefits package equity stock purchase 401k contribution incentive and recognition programs remote work flexibility telecommuter policy compliance Responsibilities Oversee complex state implementation and operational compliance for PBM transparency, pricing, and formulary requirements Lead resolution of readiness gaps, testing findings, and post-go-live monitoring to stabilize launches Provide targeted compliance support for high-risk implementations and regulator-facing matters during go-lives Serve as senior compliance escalation point for regulatory actions, market examinations, and enforcement actions affecting 50-state Commercial/Exchange operations Lead preventative enablement and predictive design efforts across compliance tools and data platforms Embed compliance processes early in business design and partner with Legal, Regulatory Affairs, Finance, and Operations Support CAA/HIX transparency implementation and evidence readiness across delegated pharmacy operations Oversee specialized PBM focus areas such as prior authorization, utilization management, and network pricing/access Key requirements 7+ years of leadership in PBM/healthcare regulatory compliance with multi-state or federal scope 3+ years leading cross-functional regulatory change and remediation post-audit Working knowledge of PBM pricing, reimbursement, network, formulary, utilization management, transparency, and Exchange compliance Executive communication, people leadership, and influence across Legal, Regulatory Affairs, Finance, Product, Operations, and client teams Ability to apply automation while maintaining regulatory judgment and accountability executive communication cross-functional collaboration influence and leadership PBM pricing, reimbursement, network, formulary, utilization management, transparency, Exchange compliance concepts automation usage in regulatory contexts RxComet