VP, Senior Legal Counsel - Caremark

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Position Summary

The VP & Senior Legal Counsel for CVS Caremark is responsible for all legal matters related to PBM state audits and market conduct exams, state and federal regulatory matters, PBM clinical programs and Aetna pharmacy benefit. The VP & Senior Legal Counsel will act as a subject matter expert and provide timely, practical and actionable legal guidance enabling the business to reach its strategic goals.

This role requires the highest degree of integrity and ability to influence and advise senior leaders within the organization. The individual should be a strong communicator with the ability to build enduring relationships and accomplish objectives both directly and through influencing other areas of the business.

Major Responsibilities:

• Manage a team of attorneys responsible for advising the PBM business on implementing and complying with new laws and regulations, while achieving strategic goals.
• Anticipate and identify legal issues affecting Aetna’s pharmacy benefit and proactively develop effective and practical legal strategies.
• Oversee PBM state audits, market conduct exams and investigations, working collaboratively with Compliance, Internal Audit and other business areas.
• Act as subject matter expert on major health care laws and regulations, including the Affordable Care Act (encompassing nondiscrimination in health programs and activities, health care consumer protections, transparency in coverage, etc.), the Mental Health Parity and Addiction Equity Act, the Consolidated Appropriations Act, 2021 (encompassing the No Surprises Act and transparency in health care) and ERISA.

• Supporting PBM clinical programs, including formulary development, Pharmacy & Therapeutics Committee, utilization management, and accreditation (e.g., URAC, NCQA).

Required Qualifications

• 10+ years of legal experience in analyzing federal and state laws and regulations, advising businesses on compliance and negotiating with governmental agencies
• Strong knowledge of health care law
• Experience leading a large team of legal professionals
• Travel as needed

Preferred Qualifications

• Law firm experience with some in-house and/or government experience preferred.
• Expertise in health care law, including familiarity with issues relevant to pharmacy benefit plans and government regulation and enforcement.
• Strong verbal and written communication skills, including the ability to communicate concisely.
• Excellent ability to integrate legal guidance with business goals. Must be able to understand and creatively support business objectives.
• The ability to work collaboratively in a large, complex corporate structure.
• Initiative, drive and self-confidence.
• Inspiring leader with a track record of building high performing teams.
• Ability to develop a deep understanding of the business and maintain positive relationships with colleagues at all levels of the organization.
• Comfortable in a fast-paced environment, with ability to successfully manage many projects simultaneously.
• Ability to work Hybrid Model (in office Tuesday / Wednesday / Thursday) - Dallas, TX/Chicago, IL/Woonsocket, RI/ Hartford, CT/Scottsdale, AZ/New York City, NY

Education

Juris Doctorate degree and admission to a state bar is required

The typical pay range for this role is:
$250K-$350K

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.

In addition to your compensation, enjoy the rewards of a