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Optum

Associate General Counsel, Pharmacy Programs - Remote

Posted Yesterday
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In-Office or Remote
Hiring Remotely in Minnetonka, MN
135K-231K Annually
Senior level
In-Office or Remote
Hiring Remotely in Minnetonka, MN
135K-231K Annually
Senior level
Provides legal counsel and strategic guidance for pharmacy benefit programs across Commercial, Exchange, and Medicaid products. Advises on formulary development, drug coverage, utilization management, regulatory compliance, pharmacy operations, vendor agreements, audits, investigations, and strategic initiatives. Partners with clinical, compliance, product, operations, and business leaders to mitigate legal risk and implement compliant solutions. Also reviews AI-enabled initiatives and advises senior leaders on complex legal, regulatory, and operational matters.
The summary above was generated by AI
Requisition Number: 2387229
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.
UnitedHealthcare is seeking an experienced attorney to provide legal counsel and strategic advice in support of pharmacy benefit programs across Commercial, Individual & Family Plan (Exchange), and Medicaid lines of business. This role partners closely with pharmacy, clinical, product, operations, compliance, regulatory, and business leaders to develop and implement pharmacy strategies that advance member access, affordability, quality, and regulatory compliance.
The successful candidate will provide practical, solution-oriented legal guidance regarding pharmacy benefits, formulary and drug coverage programs, clinical initiatives, pharmacy operations, vendor relationships, and evolving state and federal regulatory requirements. The attorney must be able to translate complex legal requirements into actionable business guidance while balancing legal risk, operational objectives, and member impact.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
  • Provide legal counsel regarding pharmacy benefit design, administration, and operations across Commercial, Exchange, and Medicaid products
  • Advise business and clinical stakeholders regarding formulary development, drug coverage policies, utilization management programs, prior authorization requirements, and related pharmacy initiatives
  • Support Pharmacy & Therapeutics (P&T) Committee governance and associated legal and regulatory considerations
  • Counsel pharmacy leadership regarding state and federal laws, regulations, agency guidance, and enforcement developments affecting pharmacy benefit programs
  • Advise on implementation of new regulatory requirements and assist with development of compliant operational solutions
  • Partner with compliance, regulatory, product, and operational teams to evaluate legal risks and develop mitigation strategies
  • Review and negotiate contracts and other arrangements involving pharmacy vendors, PBMs, clinical partners, and related service providers
  • Support regulatory examinations, audits, investigations, and responses to governmental inquiries
  • Provide legal support for strategic initiatives involving pharmacy affordability, access, clinical innovation, and member experience
  • Deliver practical guidance to senior leaders on complex legal, regulatory, and business issues
  • Collaborate effectively across Legal, Compliance, Government Affairs, Product, Clinical Services, Finance, and Operations teams
  • Review AI-related initiatives and provide legal guidance on the development, implementation, and use of AI-enabled tools and solutions; identify opportunities to leverage AI to improve efficiency, streamline processes, and enhance legal and business operations

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
  • Juris Doctor degree and active license to practice law
  • 5+ years of relevant legal experience with a law firm, governmental agency, or as in-house counsel
  • 1+ years of experience with a health insurer, healthcare organization, PBM, or other relevant organization
  • Experience interpreting and applying healthcare regulatory requirements
  • Experience counseling business leaders regarding complex regulatory and operational issues
  • Experience providing legal advice in a highly regulated environment
  • Demonstrated ability to analyze complex legal issues and provide practical, risk-based recommendations
  • Proven solid written and verbal communication skills
  • Demonstrated ability to influence stakeholders and build consensus across multiple functions
  • Ability to manage numerous competing priorities in a fast-paced environment
  • Experience supporting healthcare products, healthcare operations, clinical programs, reimbursement activities, or pharmacy-related initiatives

Preferred Qualifications:
  • Supporting pharmacy benefit programs, pharmacy operations, or pharmaceutical-related matters
  • Advising managed care organizations, health insurance companies, PBMs, provider organizations, or life sciences organizations
  • Supporting formulary development, drug coverage determinations, utilization management programs, or P&T Committee processes
  • Supporting Commercial, Exchange, and/or Medicaid products
  • Supporting state insurance regulatory examinations, investigations, or audits
  • Negotiating healthcare, pharmacy, clinical, or vendor agreements
  • Understanding of pharmacy economics, affordability initiatives, and healthcare cost-management strategies
  • Advising executive leaders on high-profile enterprise initiatives
  • Leading cross-functional projects involving regulatory or operational change

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $134,600 - $230,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.
UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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