Senior Managing Counsel-Pharmacy Network Operations

Cigna Group

St. Louis (MO)

Remote

USD 197,000 - 328,000

Full time

5 days ago
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Benefits offered by this job

Annual bonus opportunity
Long-term incentive plan
Comprehensive healthcare benefits

Job summary

The Cigna Group is seeking a senior leader to oversee legal support for the pharmacy network operations within its PBM organization. The role will guide strategic initiatives, manage contracting and regulatory risk, and partner with senior leadership to balance business objectives with compliance.

The successful candidate will have extensive healthcare regulatory and PBM experience, proven people leadership, and the ability to navigate complex federal and state laws to deliver practical

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 substantial healthcare regulatory and transactional experience.
  • 6+ years of direct PBM legal experience supporting pharmacy benefit management operations, pharmacy networks, or related PBM functions.
  • 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 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.

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

Leadership
Strategic thinking
Communication
Risk management

Education

Juris Doctor (JD)
Bar licensure in the United States

Job description

This is a leadership position responsible for managing a team of attorneys supporting the pharmacy network operations function of the Company's Pharmacy Benefit Management (PBM) business and its affiliates. The role serves as primary legal counsel to pharmacy network operations leadership, providing strategic legal guidance on operational, regulatory, transactional, and business matters impacting the PBM supply chain.

The successful candidate will possess significant PBM legal experience, demonstrated people leadership experience, and a strong understanding of the federal and state laws governing pharmacy benefit management, pharmacy networks, and the healthcare supply chain. This individual will partner closely with business leaders to support strategic initiatives, mitigate risk, and deliver practical legal solutions in a complex and evolving regulatory environment.

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 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.

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. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.

About The Cigna Group

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.

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.

If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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.

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