Advisor, Network Compliance

Job Description

What Network and Payor Relations contributes to Cardinal Health

The Advisor, Network Compliance plays a critical role in safeguarding the Pharmacy Services Administrative Organization’s (PSAO) network integrity by ensuring adherence to both PBM and PSAO contractual obligations and the compliance standards of its member retail pharmacy providers. This position involves monitoring, detailed investigation, and collaborative efforts to navigate complex regulatory landscapes and contractual agreements, ultimately mitigating risks and fostering a compliant pharmacy network.
 

Responsibilities

• Serve as a Subject Matter Expert (SME) on PBM contract, Provider Manual, and relevant regulatory requirements pertinent to member pharmacies.
• Develop and maintain resources to support internal understanding and ensure PSAO member pharmacies have access to essential compliance information.
• Foster member compliance through various communication and support channels.
• Conduct thorough investigations into potential PSAO member compliance issues, utilizing available data and information sources.
• Collaborate with legal counsel to prepare and issue any official notices required.
• Work with relevant partners to support investigations and ensure member adherence.

• Serve as an SME on PBM contract terms, accessing internal resources for key terms and conditions.
• Serve as an SME on PBM regulatory requirements (federal and state), staying informed about newly enacted legislation and maintaining internal knowledge bases.
• Request and review recurring and ad hoc PBM compliance reporting, leveraging data and collaborating with analytics teams.
• Collaborate with Managed Care teams on PBM inquiries, and accurately document, summarize, and escalate PBM non-compliance issues.

Qualifications

• Bachelor's degree in a relevant field (e.g., Healthcare Administration, Business, Legal Studies) or equivalent practical experience, preferred
• 3-5 years of experience in compliance, PBM operations, pharmacy regulatory affairs, or a related healthcare field, preferred
• Strong understanding of PBM contracts, federal and state regulatory requirements impacting pharmacies and PBMs, and pharmacy operations.
• Exceptional analytical, research, and problem-solving skills.
• Demonstrated ability to manage multiple tasks, prioritize effectively, and work independently under general supervision.
• Excellent written and verbal communication skills, with the ability to collaborate effectively with diverse internal and external stakeholders, including legal counsel, data analysts, PBM representatives, and member pharmacies.

What is expected of you and others at this level

• Applies comprehensive knowledge and a thorough understanding of concepts, principles, and technical capabilities to perform varied tasks and projects
• May contribute to the development of policies and procedures
• Works on complex projects of large scope
• Develops technical solutions to a wide range of difficult problems
• Solutions are innovative and consistent with organization objectives
• Completes work; independently receives general guidance on new projects
• Work reviewed for purpose of meeting objectives
• May act as a mentor to less experienced colleagues

Anticipated salary range: $67,500 - $96,300

Bonus eligible: No

Benefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

• Medical, dental and vision coverage
• Paid time off plan
• Health savings account (HSA)
• 401k savings plan
• Access to wages before pay day with myFlexPay
• Flexible spending accounts (FSAs)
• Short- and long-term disability coverage
• Work-Life resources
• Paid parental leave
• Healthy lifestyle programs

Application window anticipated to close: 5/29/2026 *if interested in opportunity, please submit application as soon as possible.

The salary range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate’s geographical location, relevant education, experience and skills and an evaluation of internal pay equity.

Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.

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