Pharmacy Team Attorney

Who We Are

Machinify is a leading healthcare intelligence company with expertise across the payment continuum delivering unmatched value transparency and efficiency to health plans. Deployed by over 75 health plans including many of the top 20 and representing more than 170 million lives Machinifys AI operating system combined with proven expertise untangles healthcare data to deliver industry-leading speed quality and accuracy. Were reshaping healthcare payment through seamless intelligence.

Location: This position will be hybrid located in our La Grange KY office.

About the Opportunity

At Machinify were constantly reimagining whats possible in our industrycreating disruptively simple powerfully clear ways to maximize our clients financial outcomes today and drive down healthcare costs tomorrow.

As part of the Pharmacy team you will provide legal counsel and support for the Coordination of Benefits (COB) Pharmacy operations. This role ensures compliance with federal and state laws contractual obligations and regulatory requirements related to pharmacy benefits coordination. The attorney will collaborate with internal teams external partners and regulatory agencies to mitigate risk and support business objectives. Familiarity with litigation practice mediation and settlement negotiations is a plus.

What youll do

• Identify relevant legal issues that could impact Pharmacy Operations and advise business leaders as appropriate so that informed decisions can be made.
• Provide timely and appropriate legal review and advice for the Pharmacy Operations team. This will include communicating with parties outside of Machinify to assist in the recovery efforts of the analysts.
• Monitor and interpret applicable laws regulations and guidance from CMS state insurance departments and other governing bodies.
• Identify potential legal risks and develop strategies to mitigate exposure in Pharmacy operations.
• Provide legal training to Pharmacy staff on compliance obligations and emerging regulatory trends.
• Negotiate with PBM representatives and employer group benefit managers to resolve contested Pharmacy recoveries.
• Manage and oversee litigation or disputes related to Pharmacy including coordination with outside counsel when necessary.
• Assist Client Success with legal opinions and interpretations to respond and resolve client inquiries may include participation in client or group conference calls.
• Communicate as needed to Pharmacy Operations regarding new court decisions statutes and regulations with instruction as to the effects on file handling.
• Work closely with compliance operations and pharmacy benefit management teams to ensure seamless integration of legal considerations into business processes
• Present at industry and legal conferences to promote industry understanding of Pharmacy service offerings.

What experience you bring (Role Requirements)

• Juris Doctor (JD) from an accredited law school; active license to practice law in the state of Kentucky as a member in good standing.
• Minimum 35 years of legal experience preferably in healthcare pharmacy benefits or insurance law.
• Familiarity with COB processes pharmacy benefit management and healthcare regulations (HIPAA ERISA CMS guidelines).
• Strong analytical and problem-solving abilities.
• Excellent written and verbal communication skills. Ability to communicate effectively throughout all levels of the organization.
• Willingness to handle disputed settlement negotiations and participate in litigation.
• Ability to manage multiple priorities in a fast-paced environment.
• Collaborative mindset with attention to detail.
• Working knowledge with Microsoft Office products.

What Success Looks Like

After 3 months

• You will have a strong understanding of the role.
• You begin building relationships and collaborating with peers.
• You develop effective time and priorities management.
• You receive initial feedback about your performance and are using it to improve.
• Youve gained confidence in your abilities and are starting to feel more comfortable in your role.

After 1 year

• You have mastered the tasks and responsibilities of the position executing them with confidence and efficiency.
• You have established a strong network of internal relationships and are recognized as a key collaborator.
• Youve been entrusted with greater responsibility indicating the companys confidence in your abilities.
• You see opportunities for career progression and personal development.

Pay range: $110000 - $135000 USD.The salary range is for Base Salary.Compensation will be determined based on several factors including but not limited to skill set years of experience and the employees geographic location.

Whats in it for you

• PTO Paid Holidays and Volunteer Days
• Eligibility for health vision and dental coverage 401(k) plan participation with company match and flexible spending accounts
• Tuition Reimbursement
• Eligibility for company-paid benefits including life insurance short-term disability and parental leave.
• Remote and hybrid work options

What values well share with you

• Ask why
• Think big
• Be humble
• Optimize for customer impact
• Deliver results

At Machinify were reimagining a simpler way forward. This begins with our employees. We are innovators who value integrity teamwork accuracy and flexibility. We do the right thing and we listen to the needs of our clients and their members. As tenured experts with unmatched experience we champion diverse perspectives that help us to better understand and serve our clients.

Our values come to life through our culture. We embrace flexible working arrangements that allow our employees to bring innovation to life in the way that best suits their productivity. We work cross-functionally abandoning silos to bring innovative and accurate solutions to market. We invest in each other through ongoing education and team celebrations and we give back to our communities through dedicating days for volunteering. Together Machinify is making healthcare work better for everyone and were passionate about a future with better outcomes for all.

We are committed to equal employment opportunity regardless of race color ancestry religion sex national origin sexual orientation age citizenship marital status disability gender gender identity or expression or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable accordance with applicable state laws we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process please contact our People Operations team at. See our Candidate Privacy Notice at: