Senior General Counsel

Description

TrueScripts Management Services is a pharmacist-founded, fully transparent Prescription Benefit Manager that has been revolutionizing the PBM industry since 2014. Our mission is to build lasting relationships by providing prescription benefit expertise at a personal and customized level to ensure optimum value at the lowest possible cost. We are committed to lowering prescription drug spending, achieving clinically effective outcomes, and always delivering Amazing Care.

Did we mention Amazing Care ? Good!

Because this is so much more than just our tagline. It is the foundation upon which our business was built. We believe that Amazing Care starts from within, and our culture is reflective of this philosophy.

Our team members enjoy:

• •A wide range of health insurance options including medical, dental and vision
• •A strong salary and bonus program
• •A robust 401k program with 6% match
• •TrueScripts is an ESOP, a team member owned company! Each year team members are allocated shares of stock through our ESOP, a Qualified Retirement plan!
• •A wellness program including financial incentives, chiropractic and massage services, and fitness stipends
• •A cohesive, family-based culture
• •Charitable contributions and volunteer time
• •Lots of celebrations!

Ok, enough about us. Here’s what we need from you: A future team members' values need to align with TrueScripts' core values of Integrity, Respect, Innovation, and Service. This match in value systems is critical for our team's chemistry and continued success. Our culture is positive, and our people possess a ‘can do, proactive attitude. Honesty and transparency are the foundation that we build upon. What sets us apart from our competitors is the programs that we bring, the education that we provide, and the utmost respect for clients and their members to assist them when and where needed.

The Sr. General Counsel serves as the company’s principal legal advisor and a key member of the Executive Committee, providing strategic and practical legal guidance across the organization. This role is responsible for helping the company navigate the highly regulated pharmacy benefit management (PBM) and healthcare environment while balancing legal and regulatory requirements with business objectives, growth, client needs, and operational realities. The Sr. General Counsel is also expected to serve as a legal partner with plan benefit designs, cost-containment programs, and other PBM solutions, using a deep understanding of applicable laws and regulations to help the company identify lawful structures that maximize savings and value for clients and their members.

The Sr. General Counsel will provide leadership and counsel across PBM operations, healthcare and pharmacy regulation, commercial contracting, corporate governance, enterprise risk management, compliance, disputes, regulatory matters, and ESOP-related legal considerations.

The ideal candidate is a seasoned, business-minded attorney who brings strong legal judgment, hands-on execution, and meaningful experience in healthcare, pharmacy benefits, managed care, insurance, employee benefits, or PBM-related environments. Experience working with an ESOP or employee-owned organization is highly valued.

This role is designed for a practical legal leader who can identify and prioritize material risk, provide clear recommendations, and help the business move forward without unnecessary legal complexity or expense.

Requirements

Executive & Strategic Legal Leadership

• •Serve as the company’s principal legal advisor to the President/CEO and Executive Committee.
• •Provide practical legal guidance on strategic initiatives, business decisions, growth opportunities, regulatory risk, and enterprise-level issues.
• •Participate as an active member of the Executive Committee and contribute legal and risk perspectives to organizational strategy and decision-making.
• •Partner with executive and business leaders to balance legal and regulatory requirements with commercial objectives and operational realities.
• •Approach legal and regulatory issues with a solutions-oriented mindset, helping the organization identify lawful alternative structures and strategies that achieve client cost-containment and business objectives when an initially proposed approach presents unacceptable legal or regulatory risk.
• •Identify emerging legal and regulatory risks and proactively develop strategies to address them.

PBM, Healthcare & Regulatory Counsel

• •Advise leadership and business teams regarding federal and state laws and regulations affecting PBM operations and healthcare services.
• •Provide legal guidance related to claims administration, formularies, pharmacy networks, pharmacy reimbursement, rebates, benefit programs, employer-sponsored health plans, and related PBM services.
• •Advise on state PBM laws and requirements, including registration, reporting, transparency, network, reimbursement, rebate, spread pricing, and pass-through requirements.
• •Provide counsel regarding CMS requirements and Medicare and Medicaid matters relevant to PBM, health plan, pharmacy, and managed care operations.
• •Advise on ERISA, HIPAA, HITECH, privacy, data security, fraud and abuse, and other applicable healthcare regulatory requirements.
• •Monitor legislative, regulatory, and enforcement developments and translate changes into clear, actionable recommendations for leadership and impacted business teams.
• •Partner with Compliance, Operations, Clinical, Client Services, Sales, Finance, and other departments to ensure legal requirements are incorporated into business processes.

Plan Benefit Design Innovation and Cost Containment

• •Partner with Clinical, Operations, Client Services, Sales, Finance, Compliance, and other business leaders to legally , evaluate, , innovative pharmacy benefit structures and cost-containment strategies designed to reduce plan sponsor and member costs while maintaining compliance with applicable federal and state laws and regulations.
• •Provide legal guidance regarding the design of customized plan benefit structures, including evaluating how ERISA, the ACA, HIPAA, CMS requirements, Medicare and Medicaid rules, state insurance and PBM laws, tax requirements, fiduciary obligations, and other applicable laws may affect proposed cost-containment strategies.
• •Work collaboratively with business and clinical teams to develop legally compliant alternatives when regulatory requirements, contractual limitations, or other legal considerations prevent implementation of a proposed benefit or cost-containment strategy.
• •Help legally translate cost-containment concepts into scalable PBM products and client solutions, including appropriate plan-document provisions, participant communications, contracts, policies, disclosures, and operational processes.

Commercial Contracting

• •Draft, review, negotiate, and oversee key commercial agreements, including:
• •PBM services agreements (PSA)
• •Client and payor agreements
• •Pharmacy network agreements
• •Manufacturer rebate and service arrangements
• •Vendor and technology agreements
• •Data-sharing and data-use agreements
• •Business Associate Agreements
• •Confidentiality and Non-Disclosure Agreements
• •Other strategic and commercial agreements
• •Establish contract standards, templates, playbooks, and approval processes that support efficient and consistent contracting.
• •Identify material contractual risks and provide practical recommendations for mitigating those risks.
• •Partner with Sales, Client Services, Operations, Finance, and other stakeholders to support client retention, RFPs, new business opportunities, and strategic initiatives.

Corporate Governance, ESOP & Enterprise Risk

• •Provide legal counsel regarding corporate governance, board matters, policies, procedures, and organizational risk.
• •Advise leadership regarding ESOP-related legal, governance, fiduciary, transaction, and compliance matters.
• •Support appropriate g