Sr. Legal Counsel – Caremark

AetnaFull TimeHybrid

Job Description
As Senior Legal Counsel, you will provide strategic legal advice to internal business partners with respect to healthcare regulations and laws. You will proactively work collaboratively with business partners and other attorneys on a wide variety of regulatory matters, including network contracts and legal and regulatory compliance issues.

You will identify legal and business risks and solutions that balance legal risks and business objectives and provide forward thinking strategic advice. You will be expected to develop a keen understanding of the business and operational goals of assigned internal clients and work diligently to develop and maintain positive relationships with clients at all levels of the organization. You will recommend practical and sound advice to internal business partners on legal issues related to business objectives and take an active role in driving projects to a final result.

Responsibilities will include healthcare regulatory work supporting CVS Caremark. In addition to CVS Caremark, you may provide support to various parts of the CVS Health enterprise.

As part of the Legal team, you will work with a dynamic in-house legal department and play a key role in supporting the business.

You’ll make an impact by:
• Advising clients with respect to the application of federal and state laws and regulations to CVS Caremark business activities.
• Supporting Provider Network management activities, including strategy and oversight, for pharmacy network contracts.
• Supporting Provider Network management activities, including strategy and oversight, regarding credentialing, audits, suspensions, terminations.
• Providing support and management of network provider disputes in coordination with litigation attorneys.
• Assessing and providing practical and strategic advice on various state and federal laws impacting business functions, including pharmacy benefit management and provider networks.
• Providing legal expertise on company-wide initiatives, which may require legal research and advice related to various parts of the CVS Health enterprise, including one or more of the following: CVS Caremark, CVS Specialty Pharmacy, CVS Retail Pharmacy, Aetna;
• Working collaboratively with Compliance, Government Affairs, Regulatory Affairs, Provider Network and business operations teams to implement new laws and regulations for assigned areas.
• Supporting review of product portfolios and marketing materials and member/customer/provider communications pertaining to assigned areas.

Pay Range
The typical pay range for this role is:
Minimum: 170,000
Maximum: 325,000

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 an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit

Required Qualifications
The successful candidate will have a strong work ethic, be a self-starter, and able to be highly productive in a dynamic, collaborative environment. The ideal candidate will have the following experience / knowledge / ability:

• Ability to work Hybrid Model (in office Tuesday / Wednesday / Thursday)
• 7+ years legal attorney experience in a law firm and/or in-house setting that includes:
• In depth knowledge of healthcare laws, regulations and industry standards governing the provision of healthcare.
• Admitted to practice law in at least one state and in good standing of applicable bar association(s).
• Healthcare laws and regulations regarding: PBMs, pharmacy networks, HIPAA, Medicare, Medicaid, False Claims Act, Federal Anti-Kickback Statute.
• Experience working with PBMs and related laws, including pharmacy network laws, network pharmacy contracting, government PBM audits and requests for information.

Preferred Qualifications
• Experience working with state and federal government agencies.

• Juris Doctorate

Business Overview
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

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