Senior Legal Counsel, PBM - Remote Opportunity

Remote - Anywhere

Remote position available

Job Description

The ideal candidate will have PBM experience.

To provide legal advice and counsel to company officers, managers and employees in the pharmacy benefit management business. Under the general direction of the General Counsel or Associate General Counsel, this individual provides direction and legal counsel to the company’s pharmacy-related businesses, including all subsidiaries, affiliates, and joint ventures.

Essential Functions


Provide legal assistance in the following areas:
• Contracting, including pharmacy benefit management service agreements, medical pharmacy service agreements, producer and other agreements relating to the company’s general and specialty pharmacy benefits management business lines.
• Development of responses to requests for proposals/requests for information in support of the company’s pharmacy benefit businesses, and otherwise working closely with the sales and account management teams on legal issues relating to procurement and retention of customers.
• Primary management and oversight of legal support for Employer segment of pharmacy benefit management business, including supervision of two employees
• Reviewing and advising business leaders on regulatory issues, particularly those relating to ERISA, Affordable Care Act, and other federal and state laws, including fraud and abuse laws, affecting health care, particularly the administration of pharmacy benefits.
• Development of responses to requests for proposals/requests for information in support of the company’s pharmacy benefit businesses, and otherwise working closely with the sales and account management teams on legal issues relating to procurement and retention of customers.
• Providing day-to-day legal oversight and counsel on a wide range of issues in support of and working closely with colleagues involved in the company’s pharmacy benefit businesses, including development of best practices to reduce the company’s legal and regulatory risks.
• Assisting on corporate development projects, including corporate transactions, through review and identification of risks relating to such projects and transactions;
• Identifying and assisting in the resolution of disputes and inquiries from customers, other business partners, and governmental/regulatory agencies.
• Other legal advice and tasks as requested by senior management.

Scope of Position
• This position will require the individual to perform both lawyer and manager roles.
• The responsibilities of this position require the individual to research, evaluate, interpret and resolve problems. Further, the individual guides and advises corporate officers and managers to ensure they are fully aware of the legal issues relating to and ramifications of their actions and decisions.
• In addition, the individual will manage a high-volume area and be required to develop and improve processes for completion of contracts and legal aspects of proposal responses.
• Key internal contacts include all levels of staff and management regarding legal implications of business activity. Key external contacts include communication with customers and their lawyers, providers and other vendors and their lawyers, and state and federal government regulators.
• The individual in this position must remain current with legal issues affecting the company, the health care industry and pharmacy benefits management business.
• The individual acts within corporate policies and guidelines, and according to the tenets of behavior of the legal profession.

Minimum Requirements
• Education: Juris Doctor
• Experience: 8-12 years
• Job Specific: Pharmacy Benefit Management (PBM) experience or experience in healthcare with focus on administration of pharmacy benefits strongly preferred.
• Computer Skills: Microsoft Word, Excel
• Licenses, Certifications, etc.: Bar Admission

Preferred Qualifications
• Strong problem solving skills, strong written and oral communication skills, independent, organized, self-starter.
• Ability to handle multiple assignments/tasks at the same time and to exercise sound judgment regarding prioritization of workload.
• Possess knowledge of the pharmacy benefit management industry and related regulatory environment.

General Job Information

Title

Senior Legal Counsel II- Remote Opportunity

Grade

31

Job Family

Legal Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

3/4/2019

Date Requisition Created

3/2/2019

Minimum Qualifications

Education

JD (Required)

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

  • Experience in the managed health care industry.
  • Knowledge of EAPs and laws affecting EAPs, including drug-free workplace laws, Privacy Act and other confidentiality laws.
  • Knowledge of ERISA and health care reform law.
  • Admitted to practice law in at least one state.
  • Excellent written and verbal communications/advocacy skills, ability to work independently, ability to fashion practical business solutions to complex legal situations, negotiation skills.
  • General knowledge of the behavioral health care industry and regulatory environment.
  • 10+ years of experience in a law firm, corporate or government setting practicing in a legal specialty area of relevance.
  • 7+ years of legal experience in federal benefits laws and/or contracting with the federal government.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.

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