Senior Legal Counsel - Pharmacy Benefit Manager (PBM)

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

As a Senior Legal Counsel, Pharmacy Benefit Manager (PBM) you will provide legal guidance, interpretation, advice and recommendations for action to internal stakeholders and senior/executive management regarding federal/state regulations in the healthcare industry. Serves as a subject matter expert by providing legal advice and interpretation of newly enacted legal requirements.

Major Responsibilities:

• Provides advanced legal advice and counsel to promote the company's mandates and protect the overall interests of the company.
• Prepares communications with state regulators, examiners, and/or consultants with expected deadlines/short timelines.
• Researches and analyzes state laws and regulations.
• Performs legal review and assessment of any adverse state market conduct exam findings and consent orders.
• Identifies and reviews legal risk for business areas/subject matter experts for purposes of assessing market conduct impact and corrective action plans.
• Provides legal expertise on company-wide initiatives, which may require legal research and advice related to various parts of the CVS Health enterprise.
• Works collaboratively and cross functionally with a variety of areas including members of the law department, Compliance, Government Affairs, Regulatory Affairs, and business operations teams to implement new laws and regulations for assigned areas.
• Assists with onboarding junior-level staff to promote the development of departmental capabilities.

• 8+ years of legal attorney experience in a law firm and/or in-house setting
• Mastery of problem solving and decision making skills
• Mastery of collaboration and teamwork
• Mastery of growth mindset (agility and developing yourself and others) skills
• Mastery of execution and delivery (planning, delivering, and supporting) skills
• Mastery of business intelligence

• In depth knowledge of healthcare laws, regulations and industry standards governing the provision of health plans and healthcare including, for example, Affordable Care Act, Medicare, Medicaid, ERISA, state any willing provider and other state provider network issues.
• Experience working with state and federal government agencies, healthcare laws and regulations.
• Experience working with PBMs and/or the pharmacy division of a health plan and/or with health plans.

JD required

Bachelor's Degree required

The typical pay range for this role is: