Counsel, Pharmacy Benefits and Services

JOB DESCRIPTION:

Provides legal analysis on a broad array of issues and suggests solutions affecting the pharmacy benefit management ("PBM") business.

Handles complex issues and effectively communicates relevant guidance to internal partners and stakeholders and external clients.

Has strong legal analytical, research, and writing skills.

Able to work with impacted businesses to provide strategic advice based on review of PBM-focused laws and regulations.

Able to identify the degree of legal risk associated with an issue.

Strong knowledge of regulatory environment affecting the PBM business.

Deals directly with internal partners and stakeholders and external clients.

Manages completion of special projects.

May work with outside counsel.

ROLE SUMMARY:

Counsel will be responsible for providing regulatory legal support to enterprise entities offering PBM services in the commercial business segment and the delivery of ancillary pharmacy services.

The commercial segment thrives in a dynamic, fast-growing, and highly regulated industry that services customers spanning several plan-types, including employee group plans, individual and family plans, workers' compensation, and state government plans, among others.

Legal support includes reviewing, analyzing, and preparing summaries for new and existing state and federal PBM and pharmacy laws, responding to inquiries, and reviewing communications from colleagues in PBM and pharmacy operations, Product, Compliance, and within the Legal department.

This position requires a general working knowledge of common pharmacy, PBM and related laws, including pricing and appeals, licensing, rebates, transparency, anti-steering, regulatory reporting, network structure and exclusivity, prohibited acts, and mail-order, among others.

ESSENTIAL FUNCTIONS:


* Review new and existing laws and regulations to determine impact to pharmacy and PBM operations and prepare written summaries of such laws and regulations.


* Review member-facing communications.


* Provide routine guidance to business units in response to internal (business or compliance) and external (government or client) inquiries regarding relevant law.


* Serve as a regulatory liaison for new law implementation working groups.


* Provide support to other legal team members, such as business counsel, as needed to manage complex issues involving a regulatory component.

QUALIFICATIONS:


* J.D.

from ABA accredited law school/Bar membership required.


* At least 5 years corporate legal department or law firm experience.

Experience in PBM or pharmacy law strongly preferred.


* Excellent written and oral communication skills, with the ability to distill complex regulatory issues into practical, actionable legal advice.


* Demonstrated contributor with an execution mindset, project-management skills, strong analytical skills and intellectual rigor, collaboration mindset, high personal integrity, and commitment to providing the h...