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Posted April 20, 2024

Legal Counsel (Healthcare/Regulatory)

EmpiRx Health
TELECOMMUTE Remote Full Time
Reference: EmpiRxHealth97m3XSaJ1d
Who We Are:

EmpiRx Health is the leading clinically-driven, customer-first PBM company that puts the pharmacist at the center of its service model to optimize member care while substantially reducing costs for plan sponsors.

What We Do:

We place more emphasis on member care than any other PBM by focusing on health outcomes first. Our pharmacists and clinicians are at the center of everything we doand our population health solution delivers tailored strategies for our clients.

Who We're Looking For:

EmpiRx Health is experiencing unprecedented growth, and we're seeking to add a Legal Counsel (Health Care Regulatory) to our team. Legal Counsel will partner with the General Counsel and business stakeholders on all regulatory and compliance matters, and other legal needs. Legal Counsel should have general health care and/or PBM experience and knowledge and is expected to understand and to apply federal laws and regulations such as HIPAA, ERISA, the ACA, and the CAA, and state laws and regulations pertaining to the licensing, reporting requirements, and operational requirements of PBMs and the privacy and security of patient information.

Legal Counsel supports business stakeholders in a wide range of activities including state licensing, contracting, applicability of regulation to operational needs including group plans (ERISA and non-ERISA), as well as instituting and managing compliance and risk mitigation strategies. Legal Counsel also provides legal support for other matters and duties as they arise and are assigned.

What You'll Do:
  • Advise on various federal and state health regulatory issues, including regulations related to federal and state such as HIPAA, ERISA, the ACA, and state PBM laws and regulations, etc.
  • Assist with interpreting and completing state licensure requirements, and reporting obligations for PBM, TPA and UR
  • Negotiate, draft, evaluate and advise on contractual arrangements with entities in the healthcare space, including group health plans, healthcare providers, and other partners as needed.
  • Review and negotiate BAA, NDA, Vendor agreements
  • Update, provide and architect guidelines, training and compliance program in the areas of healthcare regulatory compliance such as HIPAA and other regulations pertaining to PBM
  • Assist with privacy and HIPPA issues
  • Handle fast paced and high-volume workload
  • Identify legal and compliance issues and business risks and offer practical advice
  • Work under the leadership of the General Counsel

What You Need:
  • JD, admission to a state bar, 8+ years of healthcare regulatory experience at a combination of a top-tier law firm and in house companies (preferably high growth)
  • Strong preference for candidates with PBM regulatory experience for ERISA plans
  • Creative problem-solver, comfortable with ambiguity, complexity, and nuance.
  • Excellent legal and business judgment
  • Ability to translate complex legal issues and risks into understandable concepts the team and other individuals with non-legal backgrounds can execute on
  • Thrive on being pushed and challenged. Ability to communicate effectively both in written form and verbally
  • Willingness to learn new subject matters quickly and take on and drive projects from start to finish

Additional Qualifications
  • Solid interpersonal skills and Team player
  • Highly motivated with the ability to support timely decisions

Why Join Us:
  • EmpiRx Health is on an extraordinary journey where excellence meets innovation.
  • We are a collaborative team that encourages groundbreaking ideas, values open dialogue, and prioritizes continuous improvement.
  • You will be part of a dynamic team where success is a shared celebration, collaboration fuels progress, and we redefine healthcare together.
  • We offer a generous and competitive benefits package.
  • You will share in the company's success through our discretionary bonus program.

EmpiRx Health is an Equal Opportunity Employer

At EmpiRx Health, we wholeheartedly embrace the power of diversity and the magic of inclusion. The kaleidoscope of unique perspectives, backgrounds, and talents fuels our innovation and sets us apart. We're not just breaking down barriers but actively erasing them to create an environment where opportunity knows no bounds. In unity, we find our strength and invite individuals from all walks of life to join us in our exhilarating journey to shape a brighter, more inclusive future together.

Your career at EmpiRx Health awaits join us in shaping the future of excellence in healthcare.
Careers - EmpiRx Health

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