Legal Counsel - PBM Market Conduct

CVS Health•Work At Home-California, CA

1d•$144,200 - $288,400•Hybrid

About The Position

As Legal Counsel, provide strategic legal and regulatory counsel to internal business partners on market conduct exams and healthcare regulations and laws. Proactively advise business partners on a wide variety of matters, collaborating with attorneys and other partners on legal and regulatory compliance. Identify business and legal risks and provide solutions that balance legal issues with business objectives. Develop an understanding of assigned clients’ business and operational goals and maintain supportive relationships with clients at all levels of the organization. Support CVS Health, particularly Caremark, by advising on investigation and enforcement matters related to PBM compliance, including state market conduct exams. Assist with developing audits and examinations of the PBM, oversee legal matters related to examinations, and support resolution of enforcement matters. Independently coordinate multiple legal issues and risk assessments in a fast-paced, high-visibility environment. Work across a highly matrixed organization on legal issues that may affect different areas of the Company. The role is part of a dynamic in-house Legal team and offers experience supporting the business and developing legal skills in a regulated environment.

Requirements

Actively practicing attorney with at least 5 years of demonstrated experience in a law firm and/or in-house setting.
Experience handling healthcare regulatory matters.
Experience interacting with government regulators or agencies and/or third-party auditors or examiners regarding healthcare matters.
Admitted to practice law in at least one state and in good standing.
Ability to travel up to 15%, including by plane.
Juris Doctor (JD) required.

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, three days onsite, in the Chicago, Illinois offices.

Responsibilities

Provide strategic legal and regulatory counsel to internal business partners on market conduct exams and healthcare laws and regulations.
Advise business partners on legal and regulatory compliance matters and identify risks and solutions that balance legal considerations with business objectives.
Develop understanding of assigned clients’ business and operational goals and maintain relationships with clients at all organizational levels.
Advise CVS Health, particularly Caremark, on investigation and enforcement matters related to PBM compliance, including 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 enforcement matters.
Coordinate and oversee multiple legal issues and risk assessments independently.
Support cross-functional legal issues in a highly matrixed organization.