Deputy General Counsel – Enterprise and Commercial
Fuze Health
full-time
Posted on:
Location Type: Remote
Location: Maryland • Montana • United States
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Salary
💰 $250,000 - $275,000 per year
About the role
- Architect and negotiate enterprise-level partnerships that combine pharmacy dispensing, hub services, data/reporting, telehealth integration, and multi-state fulfillment.
- Evaluate whether payor positioning supports proposed deal economics, assess margin risk under network limitations, and influence go/no-go decisions for enterprise initiatives based on reimbursement risk modeling.
- Lead negotiations and amendment strategies for Pharmacy Participation Agreements, PBM network contracts, reimbursement schedules, and performance/value-based constructs.
- Direct legal strategy for underpayment disputes, audit challenges, appeal strategies, recoupment responses, and contract interpretation disputes to minimize financial exposure and maximize recovery.
- Ensure alignment between state reimbursement protection statutes, specialty carve-outs, and vertical-specific addenda.
- Provide centralized legal oversight across all contractual relationships in the high-revenue, operationally complex fertility vertical.
- Negotiate participation agreements, SLA structuring, and services agreements while balancing reimbursement economics, patient access, and compliance (e.g., managing patient steerage risk).
- Oversee specialty pharmacy agreements, direct purchase agreements, Limited Distribution Drug (LDD) participation, HUB services, and prescription digital therapeutic (PDTx) distribution.
- Function as the internal strategic gatekeeper, ensuring growth initiatives remain compliant and defensible under state and federal frameworks.
- Routinely evaluate and mitigate exposure related to the federal Anti-Kickback Statute (AKS), state analogs, patient steerage risk, and referral-based compensation.
- Manage, mentor, and develop a dedicated Compliance/PBM Counsel, fostering a high-performance, collaborative legal culture.
- Oversee critical operational agreements, including courier/cold-chain logistics, technology vendors, and performance-based services, particularly where inventory loss or temperature excursions implicate reimbursement exposure.
Requirements
- J.D. from an accredited law school and active license in good standing to practice law in at least one U.S. jurisdiction
- 12–14 years of legal experience in healthcare (law firm and in-house experience highly preferred)
- Deep subject matter expertise in pharmacy operations and regulatory frameworks
- Demonstrated history of operating as a lead negotiator for complex, revenue-impacting enterprise deals within the healthcare ecosystem
- Working knowledge of payor/PBM contracting, specialty pharmacy, reimbursement economics, and healthcare fraud-and-abuse laws (AKS, FCA)
- Proven management skills with experience leading attorneys, collaborating across cross-functional executive teams, and driving enterprise-level legal strategy
- Exceptional communication and judgment, with the ability to provide rapid-turn analysis on reimbursement-dependent deals and assess strategic risk beyond black-letter contract issues.
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
- a Lifestyle Spending Account allowance each month
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
negotiationcontract interpretationreimbursement risk modelinglegal strategyaudit challengesappeal strategiescompliance managementpharmacy operationspayor/PBM contractinghealthcare fraud-and-abuse laws
Soft Skills
leadershipcollaborationcommunicationjudgmentstrategic risk assessmentmentoringhigh-performance culturecross-functional teamworkrapid-turn analysisinfluencing decisions
Certifications
J.D.active law license