PBM Senior Counsel
WellDyne
At our company, we move fast, adapt quickly, and turn challenges into opportunities—all while keeping quality at the heart of everything we do. We believe that work should be a positive and respectful place, and that with the right mindset, anything is achievable. Our Vision Fulfill the essential promise of pharmacy care and help people to live to their healthiest, happiest, and fullest potential. Our Mission To be the disruptive force that drives meaningful change within pharmacy services. Summary The Senior Counsel reports to the SVP, General Counsel and Chief Compliance Officer and is responsible for providing legal support to the Company, primarily focusing on commercial contracts and regulatory compliance. The Senior Counsel will provide input on a variety of legal matters, including whether to send matters to outside counsel and assist in the oversight of outside counsel as necessary. Essential Duties & Responsibilities Contracting, including pharmacy benefit management service agreements, pharmacy service agreements, and other agreements relating to the company’s general and specialty pharmacy benefits management (PBM) business lines. Development of responses to requests for proposals/requests for information in support of the Company’s PBM business, and otherwise working closely with the sales and account management teams on legal issues relating to procurement and retention of customers. Reviewing and advising business leaders on regulatory issues, particularly those relating to pharmacy operations, pharmacy licensing, PBM licensing, ERISA, Affordable Care Act, and other federal and state laws, including fraud and abuse laws, affecting health care, particularly the administration of pharmacy benefits. Participate in the development and documentation of corporate policies, procedures and programs. Monitor the development of the Corporate Compliance Program and provide assistance to the Chief Compliance Officer. Familiarize management with specific regulatory and fraud and abuse risks. 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. Education and Experience Juris Doctor Degree Required. Must be a licensed attorney in at least one state with the ability to obtain in-house counsel status with the Florida Bar. Experience in healthcare preferred; may include prior law firm or corporate legal department experience. Knowledge, Skills, and Abilities Ability to identify risks and propose alternative structures to mitigate risks. Ability to handle multiple projects. Ability to work successfully in a team environment. Excellent analytical research and documentation of writing skills as demonstrated by past draft examples. Work Environment / Physical Demands This position is in a typical office environment which requires prolonged sitting in front of a computer. Requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment including operation of standard computer and phone equipment. May have occasional high stress when dealing with customers/clients. Some travel may be required.
EOE M/F/D/V
WellDyne and HealthDyne are equal opportunity employer and prohibits discrimination of any kind. All employment decisions are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, veteran or disability status, or any other protected status under federal, state, or local law. #J-18808-Ljbffr WellDyne- Morgan Stanley is seeking a litigation attorney in the Town of Florida, NY to manage arbitrations and civil litigation for its Wealth Management business. The role demands strong advocacy and analytical skills while handling a diverse docket of cases with a focus on regulatory...Senior
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