Managed Care Attorney

Position Summary

I am working with a healthcare provider looking to add a seasoned healthcare attorney with deep expertise in managed care contracting and pharmacy law, including the 340B Drug Pricing Program to their legal team. This role will provide strategic legal counsel and transactional support across a broad range of healthcare operations, with a focus on managed care agreements, pharmacy compliance, and regulatory matters. The position is hybrid in Wisconsin.

Key Responsibilities

• Lead the drafting, negotiation, and review of contracts with Managed Care Organizations (MCOs), PBMs, and pharmaceutical vendors.
• Provide legal oversight for 340B-related agreements, including contract pharmacy arrangements and third-party administrator (TPA) relationships.
• Advise on risk mitigation strategies and contractual obligations.
• Ensure compliance with federal and state healthcare laws, including 340B, HIPAA, STARK, Anti-Kickback Statute, and CMS regulations.
• Monitor regulatory developments and advise internal stakeholders on implications and required actions.
• Support audits and enforcement actions related to 340B and managed care.
• Provide counsel on dispute resolution, litigation, and arbitration related to managed care and pharmacy matters.
• Collaborate with outside counsel as needed.

Qualifications

• Juris Doctor (JD) from an accredited law school.
• Active bar license in good standing in at least one U.S. jurisdiction (Wisconsin preferred).
• Minimum of 7 years of legal experience in healthcare law, with a focus on managed care and pharmacy.
• Demonstrated expertise in the 340B Drug Pricing Program and pharmacy regulatory compliance.

Preferred Skills

• Experience working in or with integrated health systems or managed care organizations.
• Familiarity with pharmacy operations, reimbursement models, and contract pharmacy structures.
• Knowledge of payer-provider dynamics and value-based care arrangements.