Legal Counsel - Healthcare

CVS Health • Scottsdale, AZ

1d

About The Position

The Legal Counsel will provide strategic legal advice and counsel to internal business partners with respect to managed care contracting, provider arrangements, health care and pharmacy operations including 340b pharmacy, and healthcare regulations and laws. The Legal Counsel will also support the CVS Specialty and Coram managed care teams and operating units to undertake the drafting, negotiation and implementation of specialty pharmacy standalone contracting, 340B contracting, managed care payor arrangements, nurse agency contracts, and provide timely, practical and actionable legal guidance for legal and regulatory matters. The Legal Counsel will work collaboratively with CVS Health Legal, Finance, Underwriting, Compliance, Privacy and pharmacy operations to identify business and legal risks and provide solutions which balance legal issues and business objectives.

Requirements

• 5+ years of experience as an licensed attorney at law firm or in-house position in a role with working knowledge of healthcare laws and regulations that impact the specialty and infusion/pharmacy business units, including HIPAA, Home Health Agency (HHA) and ambulatory infusion suite licensing, 340B pharmacy Medicare, Medicaid (including Medicare/Medicaid billing and reimbursement issues), nurse licensing, patient safety and discharge regulations, the False Claims Act, and the Federal Anti-Kickback Statute
• Juris Doctor and active Law License in one U.S. jurisdiction

Nice To Haves

• Knowledge of laws and regulations that impact the specialty and infusion/pharmacy business units, PBMs, including HIPAA, HHA and ambulatory infusion suite licensing, Medicare, Medicaid (including Medicare/Medicaid billing and reimbursement issues), nurse licensing, patient safety and discharge regulations
• Excellent interpersonal skill and an understanding of health care regulatory and contract law

Responsibilities

• Provide strategic legal advice and counsel to internal business partners with respect to managed care contracting, provider arrangements, health care and pharmacy operations including 340b pharmacy, and healthcare regulations and laws
• Support the CVS Specialty and Coram managed care teams and operating units to undertake the drafting, negotiation and implementation of specialty pharmacy standalone contracting, 340B contracting, managed care payor arrangements, nurse agency contracts
• Provide timely, practical and actionable legal guidance for legal and regulatory matters
• Work collaboratively with CVS Health Legal, Finance, Underwriting, Compliance, Privacy and pharmacy operations to identify business and legal risks and provide solutions which balance legal issues and business objectives

Benefits

• Comprehensive and competitive mix of pay and benefits
• Medical coverage
• Dental coverage
• Vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources, based on eligibility
• CVS Health bonus, commission or short-term incentive program
• Equity award program

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Ph.D. or professional degree
• Number of Employees: 5,001-10,000 employees