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.

Position Summary

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.

Required Qualifications

• 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

Preferred Qualifications

• 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.

Education

JD required

Bachelor's Degree required

Pay Range

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.  This position also includes an award target in the company’s equity award program. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

Additional details about available benefits are provided during the application process and on Benefits Moments.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.