Legal Counsel - PBM Market Conduct

CVS Health•Woonsocket, RI

4d•Hybrid

About The Position

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. Position Summary: As Legal Counsel, you will provide strategic legal and regulatory counsel to internal business partners with respect to market conduct exams and healthcare regulations and laws. You will proactively advise business partners on a wide variety of matters and work collaboratively with other attorneys and partners on matters related to legal and regulatory compliance. You will identify business and legal risks and provide solutions which balance legal issues and business objectives. You will be expected to develop a keen understanding of the business and operational goals of assigned internal clients and work diligently to develop and maintain engaged and supportive relationships with clients at all levels of the organization. You will support CVS Health, particularly Caremark, and provide advice and legal counsel on investigation and enforcement matters related to PBM compliance (state market conduct exams); assist with the development of audits and examinations of the PBM; and oversee legal matters related to examinations and support resolution of any enforcement matters. You will independently coordinate and oversee multiple legal issues and risk assessments in a fast-paced environment with high visibility and significant importance to the organization. You will work in a highly matrixed organization and be able to support legal issues cross functionally that may impact a variety of different areas across the Company. As part of the Legal team, you will gain experience working with a dynamic in-house legal department and play a key role in supporting the business. You will further develop your skills in a regulated environment.

Requirements

Actively practicing attorney with 5+ years demonstrated experience in a law firm and/or in-house setting that includes: experience handling healthcare regulatory matters, experience interacting with government regulators or agencies and/or third-party auditors or examiners with respect to healthcare matters
Admitted to practice law in at least one state and in good standing

Nice To Haves

Strong knowledge of healthcare laws and regulations
Experience in a PBM or health plan/insurer environment
Experience in litigation or dispute resolution
Experience managing and/or collaborating with outside counsel
Willingness to work hybrid (3 days onsite) in IL Chicago offices

Responsibilities

Provide strategic legal and regulatory counsel to internal business partners with respect to market conduct exams and healthcare regulations and laws.
Proactively advise business partners on a wide variety of matters and work collaboratively with other attorneys and partners on matters related to legal and regulatory compliance.
Identify business and legal risks and provide solutions which balance legal issues and business objectives.
Develop a keen understanding of the business and operational goals of assigned internal clients and work diligently to develop and maintain engaged and supportive relationships with clients at all levels of the organization.
Support CVS Health, particularly Caremark, and provide advice and legal counsel on investigation and enforcement matters related to PBM compliance (state market conduct exams).
Assist with the development of audits and examinations of the PBM.
Oversee legal matters related to examinations and support resolution of any enforcement matters.
Independently coordinate and oversee multiple legal issues and risk assessments in a fast-paced environment with high visibility and significant importance to the organization.
Support legal issues cross functionally that may impact a variety of different areas across the Company.
Gain experience working with a dynamic in-house legal department and play a key role in supporting the business.
Further develop your skills in a regulated environment.