Senior Managing Counsel-Pharmacy Network Operations

Cigna Health and Life Insurance Company; Cool Valley (MO); Remote; USD 197,000 - 328,000; Full time

Job summary

The Cigna Group is seeking a senior attorney to lead the pharmacy network operations legal team in a remote capacity. You will serve as the main advisor on strategy, contracting, reimbursement, credentialing, and regulatory compliance for PBMs and pharmacy networks.

The role requires 10+ years of healthcare regulatory and transactional experience, 6+ years in PBM legal work, and 3+ years of leadership. You will partner with senior leaders and cross-functional teams to manage risk and drive

Qualifications

• JD from an accredited law school.
• Active license to practice law in at least one U.S. jurisdiction.
• 10+ years of legal experience, with healthcare regulatory and transactional focus.
• 6+ years of direct PBM legal experience supporting pharmacy benefit management operations.
• 3+ years of people leadership experience managing attorneys or legal professionals.
• Experience advising PBM business leaders on operational, strategic, and regulatory matters.
• Experience drafting and negotiating complex healthcare, pharmacy, network, or supply chain agreements.
• Strong knowledge of federal and state healthcare laws and regulations, including Anti-Kickback Statute, HIPAA, and related laws.
• Proven ability to think strategically, exercise sound judgment, and provide practical business-focused legal advice.
• Excellent written and verbal communication skills with the ability to influence senior stakeholders.
• Experience advising on pharmacy contracting, reimbursement, network management, credentialing, or pharmacy operations.
• Prior in-house healthcare legal experience supporting a PBM or health plan.

Responsibilities

• Lead and develop a team of attorneys supporting the pharmacy network operations business within the PBM organization.
• Serve as lead legal advisor for pharmacy network operations strategy, initiatives, and business objectives.
• Provide day-to-day legal counsel regarding pharmacy network operations, contracting, reimbursement, credentialing, network strategy, and regulatory compliance.
• Advise on state and federal laws and regulations impacting PBMs, pharmacy networks, and the healthcare supply chain.
• Draft, review, negotiate, and provide strategic guidance regarding complex healthcare and pharmacy-related agreements.
• Partner with business leaders on strategic initiatives, business transformations, and enterprise projects impacting pharmacy network operations.
• Collaborate with internal legal teams, including regulatory, compliance, privacy, litigation, and transactional counsel.
• Develop strong relationships with senior business stakeholders and serve as a trusted advisor to leadership.
• Ensure delivery of high-quality legal support while balancing legal risk and business objectives.
• Mentor, coach, and develop attorneys while promoting a collaborative and high-performing team culture.

Skills

Healthcare regulatory knowledge

PBM legal experience

Strategic advisory

Leadership

Contract negotiation

Education

Juris Doctor (JD) from an accredited law school

Job description

ESSENTIAL FUNCTIONS

• Lead and develop a team of attorneys supporting the pharmacy network operations business within the PBM organization.
• Serve as lead legal advisor for pharmacy network operations strategy, initiatives, and business objectives.
• Provide day-to-day legal counsel regarding pharmacy network operations, contracting, reimbursement, credentialing, network strategy, and regulatory compliance.
• Advise on state and federal laws and regulations impacting PBMs, pharmacy networks, and the healthcare supply chain.
• Draft, review, negotiate, and provide strategic guidance regarding complex healthcare and pharmacy-related agreements.
• Partner with business leaders on strategic initiatives, business transformations, and enterprise projects impacting pharmacy network operations.
• Collaborate with internal legal teams, including regulatory, compliance, privacy, litigation, and transactional counsel.
• Develop strong relationships with senior business stakeholders and serve as a trusted advisor to leadership.
• Ensure delivery of high-quality legal support while balancing legal risk and business objectives.
• Mentor, coach, and develop attorneys while promoting a collaborative and high-performing team culture.

REQUIRED QUALIFICATIONS

• Juris Doctor (JD) from an accredited law school.
• Active license to practice law in at least one U.S. jurisdiction.
• Minimum of 10+ years of legal experience, with substantial healthcare regulatory and transactional experience.
• Minimum of 6+ years of direct PBM legal experience supporting pharmacy benefit management operations, pharmacy networks, or related PBM functions.
• Minimum of 3+ years of people leadership experience managing attorneys or legal professionals.
• Demonstrated experience advising PBM business leaders on operational, strategic, and regulatory matters.
• Experience drafting and negotiating complex healthcare, pharmacy, network, or supply chain agreements.
• Strong knowledge of federal and state healthcare laws and regulations, including Anti-Kickback Statute, HIPAA, and other healthcare fraud and abuse laws.
• Proven ability to think strategically, exercise sound judgment, and provide practical business-focused legal advice.
• Excellent written and verbal communication skills with the ability to influence senior stakeholders.
• Experience advising on pharmacy contracting, reimbursement, network management, credentialing, or pharmacy operations.
• Prior in-house healthcare legal experience supporting a PBM or health plan.

REMOTE WORK

*remote role. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 197,000 - 328,300 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus and long term incentive plan.

BENEFITS

At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.

Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.

• medical benefits
• vision benefits
• dental benefits
• well-being and behavioral health programs
• 401(k)
• company paid life insurance
• tuition reimbursement
• a minimum of 18 days of paid time off per year
• paid holidays
• leaves of absence

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.