Pharmacy Team Attorney

Machinify; La Grange (KY); Hybrid; USD 110,000 - 135,000; Full time

Benefits offered by this job

PTO & holidays

Health, vision & dental coverage

401(k) with company match

Tuition Reimbursement

Life insurance

Disability protection

Parental leave

Remote and hybrid options

Job summary

Machinify is a healthcare intelligence company seeking an attorney to support the Coordination of Benefits (COB) Pharmacy operations. This role ensures compliance with federal and state laws, contractual obligations, and regulatory requirements within pharmacy benefits coordination.

You will identify legal issues, provide timely review, monitor CMS guidance, and mitigate risk while collaborating with internal teams, vendors, and regulators.

Qualifications

• Juris Doctor (JD) from an accredited law school; active license to practice law in Kentucky.
• Minimum 3–5 years of legal experience, preferably in healthcare, pharmacy benefits, or insurance law.
• Familiarity with COB processes, pharmacy benefit management, and healthcare regulations (HIPAA, ERISA, CMS).
• Strong analytical and problem-solving abilities.
• Excellent written and verbal communication skills across organizational levels.
• Willingness to handle disputed settlement negotiations and participate in litigation.
• Ability to manage multiple priorities in a fast-paced environment.
• Collaborative mindset with attention to detail.

Responsibilities

• Identify legal issues impacting Pharmacy Operations and advise leaders.
• Provide timely legal review and advice for Pharmacy Operations.
• Monitor CMS, state departments, and regulatory guidance.
• Develop strategies to mitigate exposure in Pharmacy operations.
• Provide legal training on compliance obligations and trends.
• Negotiate and resolve contested Pharmacy recoveries with PBM reps.
• Manage and oversee disputes and coordinate with outside counsel.
• Respond to client inquiries with legal opinions and interpretations.
• Communicate court decisions and regulations to Pharmacy Operations.
• Collaborate with compliance, operations, and PBM teams to integrate legal considerations.
• Present at industry and legal conferences about Pharmacy services.

Skills

Legal analysis

Written communication

Verbal communication

Regulatory compliance

Education

Juris Doctor (JD)

Licensed to practice in Kentucky

Tools

Microsoft Office

Job description

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.

About the Opportunity

As part of the Pharmacy team, you will provide legal counsel and support for the Coordination of Benefits (COB) Pharmacy operations. This role ensures compliance with federal and state laws, contractual obligations, and regulatory requirements related to pharmacy benefits coordination. The attorney will collaborate with internal teams, external partners, and regulatory agencies to mitigate risk and support business objectives. Familiarity with litigation practice, mediation and settlement negotiations is a plus.

What you’ll do

• Identify relevant legal issues that could impact Pharmacy Operations and advise business leaders as appropriate so that informed decisions can be made.
• Provide timely and appropriate legal review and advice for the Pharmacy Operations team. This will include communicating with parties outside of Machinify to assist in the recovery efforts of the analysts.
• Monitor and interpret applicable laws, regulations, and guidance from CMS, state insurance departments, and other governing bodies.
• Identify potential legal risks and develop strategies to mitigate exposure in Pharmacy operations.
• Provide legal training to Pharmacy staff on compliance obligations and emerging regulatory trends.
• with PBM representatives and employer group benefit managers to Negotiate resolve contested Pharmacy recoveries.
• Manage and oversee litigation or disputes related to Pharmacy, including coordination with outside counsel when necessary.
• Assist Client Success with legal opinions and interpretations to respond and resolve client inquiries –may include participation in client or group conference calls.
• Communicate as needed to Pharmacy Operations regarding new court decisions, statutes, and regulations with instruction as to the effects on file handling.
• Work closely with compliance, operations, and pharmacy benefit management teams to ensure seamless integration of legal considerations into business processes
• Present at industry and legal conferences to promote industry understanding of Pharmacy service offerings.

What experience you bring (Role Requirements)

• Juris Doctor (JD) from an accredited law school; active license to practice law in the state of Kentucky as a member in good standing.
• Minimum 3–5 years of legal experience, preferably in healthcare, pharmacy benefits, or insurance law.
• Familiarity with COB processes, pharmacy benefit management, and healthcare regulations (HIPAA, ERISA, CMS guidelines).
• Strong analytical and problem-solving abilities.
• Excellent written and verbal communication skills. Ability to communicate effectively throughout all levels of the organization.
• Willingness to handle disputed settlement negotiations and participate in litigation.
• Ability to manage multiple priorities in a fast-paced environment.
• Collaborative mindset with attention to detail.
• Working knowledge with Microsoft Office products.

Pay range: $110,000 - $135,000 USD. The salary range is for Base Salary.Compensation will be determined based on several factors including, but not limited to, skill set, years of experience, and the employee’s geographic location.

What’s in it for you

• PTO, Paid Holidays, and Volunteer Days
• Eligibility for health, vision and dental coverage, 401(k) plan participation with company match, and flexible spending accounts
• Tuition Reimbursement
• Eligibility for company-paid benefits including life insurance, short-term disability, and parental leave.
• Remote and hybrid work options

What values we’ll share with you

• Ask why
• Think big
• Be humbleDeliver results

Equal Employment Opportunity at Machinify

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/