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Associate Counsel – Pharmacy Benefit Management
Blue Cross NC. Provide legal support for Blue Cross NC’s Pharmacy Benefit Manager services, including services provided to the North Carolina State Health Plan .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Pharmacy Benefit Management, including legal support for contracts, compliance with federal and state regulations, and effective communication with stakeholders. Proficient in advising on pharmacy benefits, claims administration, and vendor management while ensuring adherence to legal and regulatory requirements.
Highest-signal resume keywords
Licensed To Practice LawPharmacy Benefit ManagementPBM Contract AdvisingRegulatory ComplianceClaims Administration
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
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Hard Skills
Legal SupportContract ReviewRegulatory RequirementsData GovernanceIssue SpottingComplex Service Agreement InterpretationPharmacy Benefit AdministrationVendor OversightPublic Records LawInsurance Regulatory Assessment
Soft Skills
Excellent Written CommunicationExcellent Oral CommunicationCollaborative Client ServiceJudgmentAdaptability
Certifications & Qualifications
Juris Doctor
Industry Keywords
Pharmacy BenefitsHealth Plan AdministrationSelf-Funded Health PlansGovernment-Sponsored Health ProgramsNorth Carolina General StatutesPublic ProcurementGovernment ContractingTransparencyRebate ArrangementsPharmacy Networks
About the role
Key responsibilities & impact- Provide legal support for Blue Cross NC’s Pharmacy Benefit Manager services, including services provided to the North Carolina State Health Plan
- Develop and maintain working knowledge of PBM contracts and related legal requirements
- Review PBM materials, communications, program documents, policy updates, vendor submissions, and other work product
- Advise business partners on PBM contractual requirements related to pharmacy administration, claims processing, formulary support, rebates, pricing, reporting, member communications, audits, and vendor performance
- Serve as legal counsel supporting the PBM business and administration of the State Health Plan PBM contract
- Advise on federal and state legal and regulatory requirements affecting pharmacy benefits and health plan administration
- Support pharmacy benefit initiatives, benefit changes, vendor integrations, member communications, reporting processes, and operational workflows
- Advise on privacy, security, data governance, confidentiality, and information-sharing requirements
- Support responses to audits, investigations, administrative inquiries, regulatory requests, compliance reviews, and information requests
- Assist with public records requests and confidentiality analyses
- Monitor legal, regulatory, legislative, and market developments and communicate implications to stakeholders
- Provide legal support for member complaints, appeals, grievances, claims administration issues, pharmacy network issues, benefit interpretation, and vendor disputes
- Develop and deliver training on legal, regulatory, contractual, and compliance topics
- Provide support on developing legal issues and perform other duties as assigned
Requirements
What you’ll need- Graduate of an accredited law school required
- 3+ years of experience in related field
- Licensed to practice law
- Experience supporting pharmacy benefit management, pharmacy benefits, health plan administration, self-funded health plans, government-sponsored health programs, or large employer group health plans
- Experience advising on PBM contracts, pharmacy benefit administration, rebate arrangements, formulary matters, pharmacy networks, specialty pharmacy, claims administration, or vendor oversight
- Familiarity with Chapter 135 of the North Carolina General Statutes, the North Carolina State Health Plan, public procurement, government contracting, and public records laws
- Experience assessing insurance regulatory requirements for governmental or self-funded health plan arrangements
- Experience advising on federal requirements impacting health plans, pharmacy benefits, privacy, data use, transparency, claims administration, or vendor management
- Experience reviewing and interpreting complex service agreements, performance guarantees, implementation requirements, reporting obligations, financial terms, and audit provisions
- Strong issue-spotting ability and demonstrated judgment
- Ability to provide timely, practical, legally supportable feedback
- Ability to translate complex legal and contractual requirements into clear, actionable guidance
- Excellent written and oral communication skills
- Collaborative approach to client service, vendor oversight, and relationship management
- Intellectual curiosity, adaptability, sound judgment, and a strong learning mindset
Benefits
Comp & perks- Work-life balance, flexibility, and autonomy
- Medical, dental, and vision coverage
- Health and wellness programs
- Parental leave and support
- Adoption and surrogacy assistance
- Career development programs
- Tuition reimbursement for continued education
- 401k match including an annual company contribution
- Annual Incentive Bonus
- Paid Time Off (PTO)