Associate Counsel PBM & Health Plan Compliance

Blue Cross and Blue Shield of North Carolina; Charleston (SC); Hybrid; USD 131,000 - 209,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Parental leave and adoption support

401k match with company contributions

Tuition reimbursement for continued ed

Job summary

Blue Cross NC seeks an Associate Counsel to support PBM services and State Health Plan contracts with a strong focus on health care regulation and data governance. The role partners with pharmacy, compliance, operations, data, finance, vendor management, and executives to ensure compliance and risk management across PBM operations.

The ideal candidate has a law degree, 3+ years of experience, and active licensure, with a proactive, communicative approach to providing practical legal guidance in

Qualifications

• Licensed to practice law in the applicable jurisdiction.
• 3+ years of experience in a related field.
• Graduate of an accredited law school required.

Responsibilities

• Develop and maintain a strong working knowledge of PBM contracts and related legal requirements.
• Review PBM-related materials and provide practical, legally supportable guidance to business partners.
• Advise internal partners on PBM contractual requirements including PBM-related operations, pricing and reporting.
• Serve as legal counsel supporting Blue Cross NC's PBM business and State Health Plan contract administration.
• Advise on privacy, data governance, and compliance obligations impacting PBM services and plan operations.
• Support implementation and ongoing administration of PBM initiatives and vendor integrations.
• Advise on privacy, security, data governance, and information-sharing requirements applicable to PBM services.
• Assist with audits, regulatory requests, and public records matters involving PBM services.
• Monitor developments affecting PBM, government health programs, and state plans.
• Provide support on member complaints, appeals, and vendor disputes.
• Develop and deliver training on legal, regulatory, and contractual topics relevant to PBM contract.
• Provide support on developing legal issues and other duties as assigned.

Skills

Licensed to practice law

3+ years of experience

Education

Graduate of an accredited law school

Job description

Blue Cross NC seeks an Associate Counsel to support PBM services and State Health Plan contracts with a strong focus on health care regulation and data governance. The role partners with pharmacy, compliance, operations, data, finance, vendor management, and executives to ensure compliance and risk management across PBM operations.

The ideal candidate has a law degree, 3+ years of experience, and active licensure, with a proactive, communicative approach to providing practical legal guidance in