Pbm Contracting Jobs in Missouri (NOW HIRING)

Job Summary At Fuze Health, we put patients first and tirelessly address the most pressing needs in healthcare. We empower millions to digitally connect with care providers, essential health resources and needed treatments – and enable care providers, employers, health plans and life sciences companies to meaningfully enhance quality, outcomes and value. We are dedicated to helping our partners evolve and modernize to meet emerging patient and marketplace needs. Fuze Health’s foundation is built upon the strategic combination of several proven, technology-powered innovators in the digital health, diagnostics, and pharmacy sectors. Our growing portfolio brings together the capabilities of industry leaders including LetsGetChecked, Truepill, and Alto Pharmacy, to create a distinctive, unified force in healthcare. Together, we have the shared vision, advanced capabilities and talented teams to deliver next‑generation solutions that patients and healthcare partners need today and into the future.

The Commercial & Healthcare Regulatory Counsel is a hands‑on attorney focused on commercial and vendor contracting with regulatory issue‑spotting. The role supports the Privacy, Compliance, Pharmacy Benefits Management and Operations teams to enable fast, compliant deals as the company scales integrated pharmacy and healthcare services under the Fuze Health (and FuzeRx) brands. The ideal candidate will have experience with pharmacy or PBM contracting and compliance matters. This is a hands‑on role suited for a versatile attorney who enjoys building repeatable processes and enabling speed‑to‑contract without owning enterprise legal strategy or department leadership. Complex or novel matters will be escalated to the Senior Counsel and/or specialized outside counsel.

• Commercial Contracting Draft, review, and negotiate commercial agreements, including pharmacy services agreements, PBM network participation agreements, payer/client agreements, specialty pharmacy arrangements, data sharing agreements, BAAs/DPAs, SaaS and technology agreements, licensing agreements, MSAs, and SOWs, using playbooks and clause libraries. Manage redlines, issues lists, internal alignment, and approval workflows through execution; memorialize deviations and approvals. Maintain and improve templates, clause libraries, and playbooks to reduce cycle time and drive consistency.
• Healthcare Regulatory Support Issue‑spot and provide practical guidance on applicable laws and regulations, such as the Anti‑Kickback Statute (AKS), Stark Law, False Claims Act, and FDA/DEA requirements relevant to pharmacy and telehealth operations, state pharmacy laws, pharmacist professional licensing, PBM network participation rules, and HIPAA/HITECH. Conduct targeted research, prepare summaries, and assist with regulatory analyses and alerts; coordinate with Compliance to ensure ownership and accountability across healthcare and pharmacy regulatory domains. Partner with outside counsel on complex or novel regulatory questions; help implement recommendations.
• Privacy & Data Protection Support Support the Privacy team on HIPAA and data protection matters, including incident response, breach investigations, and privacy compliance activities. Assist with drafting and negotiating privacy and security provisions in client and vendor agreements, including BAAs, DPAs, and security addenda. Partner with internal stakeholders to identify and remediate data handling risks; encourage privacy‑by‑design practices.
• Vendor & Procurement Contracting Draft, review, and negotiate vendor, procurement, and operations agreements (IT/SaaS, professional services, logistics/delivery, marketing vendors, clinical vendors), including MSAs, SOWs, order forms, renewals, and amendments, including vendors that support pharmacy operations, PBM services, patient support, data exchange, and related healthcare services. Partner with Procurement, Finance, Security/IT, Privacy, and Compliance on intake, diligence, and approvals (e.g., security questionnaires, BAAs/DPAs, SOC 2/ISO documents, COIs). Negotiate and document SLAs, support/uptime, data handling/retention, audit rights, business continuity, termination/transition assistance, and fee/charge guardrails.
• Cross‑Functional Collaboration & Legal Ops Provide timely, business‑oriented legal advice to Commercial, Partnerships, and Operations teams. Contribute to process improvements (e.g., workflow design, contract lifecycle management, playbook refinements, dashboards) that scale the legal function. Support communications and marketing review for external messaging, disclosures, and public statements.
• Compliance & Risk Support Collaborate with Compliance on training materials, audits, and corrective actions. Support Compliance with PBM audits by researching and advising on state pharmacy and PBM laws and reviewing PBM contractual requirements. Assist with risk assessments, internal inquiries, and remediation planning as needed.

• Qualifications J.D. from an accredited law school and active license to practice law in at least one U.S. jurisdiction. 8–10 years of legal experience (law firm and/or in‑house) in pharmacy, PBM, healthcare, or digital health; strong candidates with 5+ years will be considered. Demonstrated experience drafting and negotiating commercial and technology agreements. Experience with vendor/procurement contracting and third‑party risk management (e.g., SaaS/IT, SOWs, SLAs, security addenda, BAAs/DPAs). Working knowledge of healthcare regulatory frameworks (e.g., AKS, HIPAA, FDA, DEA, PBM, state pharmacy laws) with a willingness to deepen expertise and collaborate with specialists. Excellent communication, judgment, and organizational skills with a practical, business‑minded approach. Ability to thrive in a fast‑paced, evolving organization and manage multiple priorities effectively.
• Preferred Qualifications Experience in pharmacy or PBM‑related commercial/regulatory work, such as PBM network participation, payer/client contracting, prescription drug benefit administration, pharmacy services arrangements, specialty pharmacy, mail‑order pharmacy, manufacturer/rebate-related arrangements, or state PBM laws. Exposure to data privacy, cybersecurity, and breach response. Familiarity with regulatory frameworks applicable to telehealth, diagnostics, and clinical operations. Experience with contract lifecycle management (CLM) and legal operations tooling. Familiarity with SOC 2/ISO 27001 and vendor security due diligence processes.

Additional Physical Job Requirements Physical requirements for this role include the ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time, stoop, bend, and reach for equipment and supplies, make frequent repetitive motions required to operate a computer that include the wrists, hands and fingers, and lift, carry, push, pull, and move light objects up to 20 pounds. The role also requires the ability to effectively communicate through verbal interactions, discern auditory information, and visually perceive details to perform essential job functions. Consistent with the Americans with Disabilities Act (ADA) and similar applicable state laws, it is Fuze Health’s policy to provide reasonable accommodation to enable qualified individuals with disabilities to perform essential job functions, unless such accommodation would cause an undue hardship.

• Salary Range: $178,000 - 222,500
• Commission Eligible: No
• Travel: Yes - Required up to 10% of the time
• Location Requirement: Fuze Health is limited to individuals residing in the following states: 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 (WA), Wisconsin.
• Employment Authorization Requirement: Applicants must be authorized to work for any employer in the U.S.
• Benefits:
  • dental, vision, and multiple group medical plans to choose from
  • a 401(k) retirement savings plan
  • group life insurance
  • accidental death and dismemberment (AD&D) insurance
  • flexible spending account (FSA) and health savings account (HSA)
  • commuter benefits
  • employer‑paid short‑term (STD) and long‑term disability (LTD) insurance
  • additional supplemental insurance plans (spouse life insurance, legal insurance, an employee assistance program, home health testing kits, and a fertility medication discount program)
  • flexible vacation time, accrued paid sick time, 10 paid holidays, (2 floating holidays for full time non‑exempt employees)
  • eight weeks of paid parental leave for eligible employees, additional paid weeks for the birthing parent
  • 4 weeks paid caregiver leave
  • Lifestyle Spending Account allowance each month
• More Benefits Information Here: https://west.acrisure.com/alto-pharmacy/benefits/

Application deadline: July 16th, 2026 (deadline may be extended as needed)

Fuze Health is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, gender identity, sexual orientation, age, disability, veteran status, or any other legally protected basis. If you have a disability and require reasonable accommodation during any portion of the application or hiring process, please contact us at talent@fuzehealth.com. Fuze Health considers qualified applicants with arrest or conviction records for employment and conducts background checks consistent with applicable law, including the California, Los Angeles County, San Francisco, Philadelphia, and New York City Fair Chance laws. We are an E-Verify participating company.

Fuze Health recruiters and hiring managers may use automated decision tools to help identify candidates who match the stated job requirements, and to what extent. These tools are designed to help ensure fairness in all aspects of the hiring process by providing recruiters and hiring managers with data‑backed insights based on information provided in your resume, including work experience, education, and other skills. Fuze Health does not use automated decision tools to make hiring decisions; hiring decisions always involve human review and input. If you have any questions or would like to request an alternative process, please contact us at talent@fuzehealth.com.

To learn about Fuze Health’s privacy practices, including compliance with applicable privacy laws, please read our Privacy Notice for Job Applicants. Alto Pharmacy jobs have moved! Click to learn more: Fuze Health Careers.