Legal Manager Jobs in Springfield, MA (NOW HIRING)

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Position Summary:

As Legal Counsel, you will provide legal guidance, interpretation, advice and recommendations for action to internal stakeholders and senior/executive management regarding federal/state regulations in the healthcare industry. This role will also allow you to serve as a subject matter expert by providing legal advice and interpretation of new legal requirements.
What you will do:

• Provide legal support to CVS Health's PBM, Caremark, on commercial clinical programs, including formulary management, utilization management, and related clinical operations.

• Advise clients on the application of federal and state laws and regulations to the company's business activities.

• Research and maintain current knowledge of applicable federal and state healthcare laws, insurance laws, and regulations relevant to pharmacy benefit managers, including state PBM licensing, registration, and reporting requirements.

• Effectively communicate regulatory constraints and operational guardrails to non-legal and non-clinical partners.

• Review PBM-issued member and prescriber communications, as well as sales and marketing materials, to ensure accuracy, regulatory compliance, and consistency with approved clinical and operational standards; identify risks, recommend corrections, and confirm alignment with plan design and applicable state and federal requirements.

• Review draft responses to consumer complaints from state and federal regulators to ensure accuracy, regulatory alignment, and consistency with plan requirements; partner with business teams to verify facts, resolve discrepancies, and maintain clear, defensible documentation.

• Support market conduct examinations, regulatory audits, and accreditation surveys.

• Consult with other subject matter legal and compliance experts, including Litigation, Government Affairs, Privacy, and Compliance.

Required Qualifications:

• Actively practicing attorney with 5+ years demonstrated experience in a law firm and/or in-house setting; experience handling healthcare regulatory matters, experience interacting with government regulators or agencies and/or third-party auditors or examiners with respect to healthcare matters

• Admitted to practice law in at least one state and in good standing

• Ability to travel up to 10% (including by plane)

Preferred Qualifications:

• Mastery of problem solving and decision-making skills

• Mastery of collaboration and teamwork

• Mastery of execution and delivery (planning, delivering, and supporting) skills

• Demonstrated ability to interpret federal and state regulatory requirements, including:

  • Affordable Care Act (ACA)

  • State insurance and healthcare laws

  • Federal and state False Claims Acts

  • Federal and state Anti-Kickback Statutes

  • Mental Health Parity and Addiction Equity Act (MHPAEA)

  • Health Insurance Portability and Accountability Act (HIPAA)

  • Employee Retirement Income Security Act (ERISA)

• Willingness to work hybrid (3 days onsite) in IL Chicago offices

Education:

• Juris Doctor (JD) required

• In-House Counsel Certification (ICC) Preferred

Pay Range

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

Additional details about available benefits are provided during the application process and on Benefits Moments.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.