Senior Counsel - Healthcare Regulatory & Contracting

Our client is a rapidly growing healthcare technology company transforming how health benefits are administered through modern technology, greater transparency, and an integrated approach to pharmacy and medical benefits. The company works across the healthcare ecosystem, including employers, health plans, TPAs, unions, and other organizations, and is building technology and infrastructure designed to make healthcare benefits more efficient and effective. As part of the company's continued growth and expansion, the organization is adding an experienced attorney to its Legal team. This is a newly created position, not a backfill. It represents an opportunity for an experienced healthcare lawyer to join a growing Legal function and serve as a trusted legal advisor to senior leadership and business stakeholders. Significant Medicare Part D experience is essential for this role.

The successful candidate will bring deep substantive knowledge of Medicare and CMS requirements, combined with the ability to translate complex regulatory issues into practical advice for business leaders and operational teams. This is a highly substantive role for a lawyer who enjoys operating at the intersection of law, business, and healthcare. The attorney will serve as a subject-matter resource on Medicare issues within the Legal team while partnering closely with colleagues across Legal, Compliance, Operations, and the broader business. The position is based in Charlotte and requires a hybrid schedule of at least three days per week in the office. You will provide practical, business-oriented legal advice across Medicare and healthcare regulatory matters while supporting the company's commercial and operational activities.

• Base salary: $135-$174K annually, plus eligibility for cash bonus and to purchase equity

Responsibilities:

• Advise on Medicare Part D, health insurance, and other federal healthcare program requirements, including CMS regulations and guidance, reporting obligations, audits, and enforcement matters.
• Monitor healthcare law and regulatory developments, advise leadership on operational implications, and support implementation of new requirements.
• Assess regulatory risks associated with business operations, products, and strategic initiatives, and develop practical, operationally feasible solutions.
• Support government audits, investigations, corrective action plans, regulatory examinations, and responses to regulatory inquiries.
• Draft, review, negotiate, and advise on healthcare and commercial agreements, including rebate and delegation agreements, client agreements, network and managed care contracts, and vendor agreements.
• Develop contracting standards, templates, negotiation playbooks, and risk-management processes, partnering with Procurement, Operations, Compliance, and business teams to facilitate efficient execution.
• Support vendor selection, due diligence, onboarding, and ongoing oversight.
• Advise on healthcare fraud and abuse laws and related requirements, including the False Claims Act, Anti-Kickback Statute, and Stark Law, as well as Medicare, Medicaid, and state insurance and healthcare regulations.
• Support compliance investigations, policy development, training initiatives, and operational audits.
• Support corporate growth initiatives, product development, and strategic transactions as needed.

Required qualifications:

• J.D. from an accredited law school.
• Active license and good standing in at least one U.S. state.
• 8+ years of legal experience in a law firm, healthcare organization, health plan, PBM, managed care organization, or a combination thereof.
• Significant, hands-on experience with Medicare Part D regulatory requirements.
• Extensive experience drafting and negotiating healthcare contracts, including complex commercial, vendor, network, rebate, delegation, and/or managed care agreements.
• Strong knowledge of federal and state healthcare laws and regulations.
• Experience advising business teams in a fast-paced, highly regulated environment.
• Excellent drafting, negotiation, analytical, and communication skills.
• Strong business judgment and the ability to provide practical, solution-oriented legal advice.
• Ability to manage multiple priorities independently and work effectively across functions.
• Experience that would be particularly valuable includes:
• Current or prior in-house experience within a PBM, pharmacy organization, health plan, TPA, managed care organization, or healthcare technology company.
• Experience supporting a PBM, Medicare Advantage plan, health plan, TPA, or managed care organization.
• Experience with CMS audits, regulatory examinations, corrective action plans, or other government regulatory matters.
• Knowledge of delegated entity and first-tier, downstream, and related entity (FDR) oversight requirements.
• Experience with provider contracting and network management.
• Experience with healthcare technology, data privacy, and digital health products.
• Familiarity with Medicaid and commercial health plan regulations.
• Experience supporting mergers, acquisitions, or other strategic healthcare transactions.
• Prior law-firm training in a sophisticated healthcare practice.

If you meet the required qualifications and are interested in this role, please apply today.

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