Louis Crognale

About Louis Crognale

I’m an accomplished compliance and regulatory transformation executive with deep-rooted experience in Medicare, Medicaid, PBM operations, and health plan governance. Over the years, I’ve built a reputation as a strategic advisor and results-driven leader—trusted to guide complex organizations through high-stakes regulatory scrutiny, including CMS sanctions, OIG investigations, and federal/state audits.My approach blends operational pragmatism with a long-range vision for sustainable compliance. I’ve successfully led enterprise-wide compliance transformations, integrated the 7-Element Compliance Framework across large health systems, and built robust internal controls rooted in the Three Lines of Defense model. From modernizing compliance processes with ServiceNow, Archer, and Confluence to shaping organization-wide risk and ethics strategies, I bring a hands-on, cross-functional leadership style that drives measurable outcomes.What sets me apart is the breadth of my experience—spanning retail pharmacy, PBM integrations, FDR oversight, and executive-level regulatory affairs. I’ve partnered directly with CMS, OIG, and state DOI regulators, earning their trust while fostering a culture of accountability and transparency within the organizations I serve.I thrive on transforming compliance from a reactive function into a strategic enabler. Whether guiding large teams through compliance remediation, aligning due diligence during M&A activity, or educating senior leaders on evolving regulatory landscapes, I’m passionate about creating resilient, audit-ready organizations that uphold integrity at every level.Let’s connect if you’re focused on strengthening enterprise compliance, navigating regulatory risk, or transforming how healthcare organizations approach oversight and accountability.

Experience

1. Medicare Compliance Officer

   Centene Corporation

   Oct 2025 — Present · Delaware, OH, US

   Drive strategy and execution for Medicare Compliance, ensuring adherence to regulatory standards. • Oversee Enterprise Pharmacy Compliance to enhance operational accuracy and risk management. • Create and lead an Enterprise Risk Adjustment Compliance function to mitigate potential compliance risks across the organization.

Education

• The Ohio State University

  BS, Pharmacy

  1995 — 1999

• Deptford Township High School

  Diploma, Honors

  1990 — 1994

• Rutgers University - Camden

  transferred, Pre-Pharmacy Studies

  1994 — 1995