Overview
This role serves as the primary legal leader and strategic advisor supporting the pharmacy business within a healthcare organization focused on digital health, diagnostics, and pharmacy sectors. The Deputy General Counsel, Enterprise and Commercial, operates at the center of payor strategy, specialty manufacturer relationships, enterprise commercial transactions, and regulatory risk mitigation. This position is integral to the company’s revenue generation and growth strategy.
Responsibilities
Strategic Enterprise & Commercial Transactions
- Architect and negotiate enterprise-level partnerships combining pharmacy dispensing, hub services, data/reporting, telehealth integration, and multi-state fulfillment.
- Evaluate payor positioning to support deal economics, assess margin risk under network limitations, and influence go/no-go decisions for enterprise initiatives based on reimbursement risk modeling.
Strategy & Revenue Protection
- Lead negotiations and amendment strategies for Pharmacy Participation Agreements, PBM network contracts, reimbursement schedules, and performance/value-based constructs.
- Direct legal strategy for underpayment disputes, audit challenges, appeal strategies, recoupment responses, and contract interpretation disputes to minimize financial exposure and maximize recovery.
- Ensure alignment between state reimbursement protection statutes, specialty carve-outs, and vertical-specific addenda.
Specialty Pharmacy & Fertility Vertical Governance
- Provide centralized legal oversight across all contractual relationships in the fertility vertical.
- Negotiate participation agreements, SLA structuring, and services agreements balancing reimbursement economics, patient access, and compliance.
- Oversee specialty pharmacy agreements, direct purchase agreements, Limited Distribution Drug (LDD) participation, HUB services, and prescription digital therapeutic (PDTx) distribution.
Regulatory Compliance & Risk Mitigation
- Serve as internal strategic gatekeeper ensuring growth initiatives comply with state and federal frameworks.
- Evaluate and mitigate exposure related to the federal Anti-Kickback Statute (AKS), state analogs, patient steerage risk, and referral-based compensation.
Leadership & Operational Oversight
- Manage, mentor, and develop a dedicated Compliance/PBM Counsel.
- Oversee critical operational agreements including courier/cold-chain logistics, technology vendors, and performance-based services, especially where inventory loss or temperature excursions impact reimbursement.
Requirements
- J.D. from an accredited law school and active license to practice law in at least one U.S. jurisdiction.
- 12–14 years of legal experience in healthcare, with a preference for both law firm and in-house experience.
- Deep expertise in pharmacy operations and regulatory frameworks.
- Proven experience as lead negotiator for complex, revenue-impacting enterprise deals within healthcare.
- Working knowledge of payor/PBM contracting, specialty pharmacy, reimbursement economics, and healthcare fraud-and-abuse laws (AKS, FCA).
- Strong leadership skills with experience managing attorneys and collaborating with cross-functional executive teams.
- Exceptional communication and judgment with the ability to provide rapid-turn analysis on reimbursement-dependent deals and assess strategic risk.
Physical Requirements
- Ability to work at a computer terminal for extended periods.
- Ability to stoop, bend, reach, and perform repetitive motions with wrists, hands, and fingers.
- Ability to lift, carry, push, pull, and move light objects up to 20 pounds.
- Effective verbal communication and auditory and visual perception.
- Occasional travel required (up to 10%), including sitting for extended periods on airplanes or vehicles, lifting and carrying luggage, navigating airports, and adjusting to different time zones and climates.
Reasonable accommodations will be provided in accordance with the Americans with Disabilities Act (ADA) and applicable state laws.
Compensation & Benefits
- Salary Range: $250,000 - $275,000
- Commission: Not eligible
- Benefits include dental, vision, multiple group medical plans, 401(k) retirement savings plan, group life insurance, accidental death and dismemberment insurance, flexible spending and health savings accounts, commuter benefits, employer-paid short-term and long-term disability insurance, supplemental insurance plans, flexible vacation time, paid sick time, paid holidays, paid parental and caregiver leave, and a monthly Lifestyle Spending Account allowance.
Location & Employment Details
- This position is limited to individuals residing in select U.S. states including Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Vermont, Virginia, Washington, and Wisconsin.
- Applicants must be authorized to work for any employer in the U.S.