Pharmacy Legal Counsel – COB & Compliance (Remote)

The Rawlings Group; La Grange (KY); Hybrid; USD 110,000 - 135,000; Full time

Benefits offered by this job

Remote and hybrid work options

PTO and holidays

401(k) plan with company match

Job summary

Machinify is seeking an attorney to provide legal counsel for Coordination of Benefits (COB) Pharmacy operations, ensuring compliance with federal and state laws, HIPAA, ERISA, and CMS guidelines. The role collaborates with internal teams and external regulators to mitigate risk and support business objectives.

Responsibilities include issuing timely legal reviews, training Pharmacy staff, negotiating recoveries with PBMs, managing disputes with outside counsel, and presenting at industry

Qualifications

• JD from an accredited law school and active Kentucky license.
• 3–5 years experience in healthcare or insurance law.
• Familiarity with COB processes and HIPAA, ERISA, CMS guidelines.
• Strong analytical and communication skills.

Responsibilities

• Identify legal issues impacting Pharmacy Operations and advise leadership.
• Provide timely legal review for Pharmacy Operations team.
• Monitor CMS, state departments, and other regulators.
• Identify legal risks and mitigate exposure.
• Provide compliance training to Pharmacy staff.
• Negotiate and resolve contested recoveries with PBM reps.
• Manage disputes and coordinate with outside counsel.
• Assist Client Success with legal opinions on client inquiries.
• Communicate regulatory updates to Pharmacy Operations.
• Collaborate with compliance and PBM teams to integrate legal considerations.
• Present at industry and legal conferences.

Skills

Legal analysis

Healthcare regulatory

COB knowledge

Litigation support

Regulatory compliance

Education

Juris Doctor (JD)

Kentucky bar license

Tools

Microsoft Office

Job description

Machinify is seeking an attorney to provide legal counsel for Coordination of Benefits (COB) Pharmacy operations, ensuring compliance with federal and state laws, HIPAA, ERISA, and CMS guidelines. The role collaborates with internal teams and external regulators to mitigate risk and support business objectives.

Responsibilities include issuing timely legal reviews, training Pharmacy staff, negotiating recoveries with PBMs, managing disputes with outside counsel, and presenting at industry