Senior Legal Counsel – Pharmacy Benefit Manager

This is a fully remote position, open to applicants in Rhode Island.

📋 Description

• Offer legal guidance, interpretation, advice, and recommendations to internal stakeholders as well as senior/executive management concerning federal and state healthcare regulations.

• Act as a subject matter expert on newly implemented legal requirements.

• Provide advanced legal counsel to support company objectives and safeguard company interests.

• Draft communications with state regulators, examiners, and/or consultants while adhering to expected deadlines and tight timelines.

• Conduct research and analysis of state laws and regulations.

• Perform legal reviews and assessments of negative state market conduct exam findings and consent orders.

• Identify and evaluate legal risks for business areas and subject matter experts to understand market conduct implications and corrective action strategies.

• Deliver legal expertise on enterprise-wide initiatives that necessitate legal research and consultation across the CVS Health organization.

• Collaborate across various functions with the law department, Compliance, Government Affairs, Regulatory Affairs, and business operations teams to implement new laws and regulations.

• Support the onboarding of junior-level staff to enhance departmental capabilities.

⛳️ Requirements

• Over 8 years of legal experience as an attorney in a law firm and/or in-house environment.

• Expertise in problem-solving and decision-making skills.

• Proficiency in collaboration and teamwork.

• Strong growth mindset skills, including adaptability and the ability to develop oneself and others.

• Mastery of execution and delivery abilities, encompassing planning, execution, and support.

• Proficient in business intelligence.

• Juris Doctor (JD) degree is required.

• A Bachelor's Degree is required.

• Preferred: Extensive knowledge of healthcare laws, regulations, and industry standards governing health plans and healthcare, including the Affordable Care Act, Medicare, Medicaid, ERISA, and state provider network issues.

• Preferred: Experience with state and federal government agencies, healthcare laws, and regulations.

• Preferred: Background working with Pharmacy Benefit Managers (PBMs) and/or the pharmacy division of a health plan and/or with health plans.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial well-being.

• CVS Health bonus, commission, or short-term incentive program.

• Equity award program.