Associate Counsel, PBM & Health Plan Compliance

Blue Cross and Blue Shield of North Carolina; Idaho; Hybrid; USD 131,000 - 209,000; Full time

Benefits offered by this job

Annual Incentive Bonus

401(k) with employer match

PTO

Health benefits

Wellness programs

Job summary

Blue Cross NC is seeking an Associate Counsel to support PBM services, health plan operations, and government programs across the enterprise. The role collaborates with pharmacy, compliance, operations, data, finance, and vendor management teams to ensure contractual compliance and timely, legally sound guidance.

The ideal candidate has a JD, 3+ years of related experience, and an active law license. This hybrid role involves working with the State Health Plan and other PBM initiatives, with a

Qualifications

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

Responsibilities

• Develop and maintain knowledge of PBM contracts and related legal requirements, including vendor obligations, performance guarantees, reporting requirements, implementation milestones, financial terms, audit rights, data obligations, and operational commitments.
• Review PBM-related materials, program documents, policy updates, vendor submissions, and other work products to provide practical, legally sound guidance to business partners.
• Advise internal business partners on PBM contractual requirements, including pharmacy benefit administration, claims processing, pricing, reporting, audits, and vendor performance.
• Serve as legal counsel supporting Blue Cross NC's PBM business, including administration of the State Health Plan PBM contract.
• Advise on privacy, data use, transparency, claims administration, and other compliance obligations.
• Support implementation and ongoing administration of PBM initiatives and vendor integrations.
• Advise on privacy, security, data governance, and information-sharing requirements.
• Support responses to audits, investigations, regulatory requests, and other information requests involving PBM services.
• Assist with public records requests, confidentiality analyses, and protection of sensitive information.
• Monitor developments affecting PBM, government health programs, and State Health Plan operations.

Skills

Business Contracts

Contract Negotiations

Regulatory Compliance

Legal Research

Contract Management

Education

Juris Doctor (JD)

Job description

Blue Cross NC is seeking an Associate Counsel to support PBM services, health plan operations, and government programs across the enterprise. The role collaborates with pharmacy, compliance, operations, data, finance, and vendor management teams to ensure contractual compliance and timely, legally sound guidance.

The ideal candidate has a JD, 3+ years of related experience, and an active law license. This hybrid role involves working with the State Health Plan and other PBM initiatives, with a