Job Description

We exist for workers and their employers -- who are the backbone of our economy. That is where Centivo comes in -- our mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills.

Summary of role:

We are looking for in-house member of our legal team. The role requires knowledge of and experience with federal and state laws and regulations unique to the healthcare industry, and in particular, self-insured/self-funded health plans.

Reporting to our Chief Legal Officer with support from outside counsel, this role is an opportunity for a healthcare attorney to not only advise the company on a diverse array of legal and business issues, but to continue to help Centivo build its in-house counsel function and related processes. Your work will fall into four areas: contract negotiation, regulatory advisory and matter management, disputes and matter management, and M&A and due diligence. Across all four areas, you will help shape how the legal team works. We use Ironclad for contract management, and there are ample opportunities to build and improve legal processes through process documentation, templates, standard workflow automation, and use of artificial intelligence (AI).

Responsibilities Include:

Contract Negotiation (Clients and Vendors)

• Draft, negotiate, redline, and finalize agreements with clients, vendors, and partners, including:
• Employer administrative services agreements (ASAs)
• Client and vendor agreements (MSAs)
• Data security and privacy agreements, e.g., Business Associate Agreements (BAAs) and Data Transfer/Utilization Agreements (DUAs)
• Channel partnership joint-marketing agreements
• Integrate contract intake with other relevant systems (eg SalesForce), manage the contract inventory and oversee executed agreements in Ironclad, including file management and renewal tracking

Regulatory Advisory and Matter Management (Privacy, ERISA, DOL, Licensing)

• Advise on privacy and data protection requirements, including HIPAA and state law, and manage related matters
• Advise on ERISA and Department of Labor (DOL) requirements that affect self-funded plans, TPA operations, and our clients as Plan Sponsors, and manage related inquiries and matters
• Support licensing compliance, including medical licensing, corporate practice of medicine statutes, and individual producer and TPA licensing
• Support the virtual primary care business on legal and regulatory questions

Disputes and Matter Management

• Manage disputes with clients, vendors, and others, contract and otherwise, from early resolution through formal proceedings
• Coordinate outside counsel, track matters through resolution, and keep business stakeholders informed

M&A and Due Diligence

• Support acquisitions, investments, and other corporate transactions, including legal due diligence
• Review diligence materials, flag risks in plain language, and help prepare transaction documents with outside counsel

Qualifications:

• JD degree from an accredited law school
• Admission to the practice of law in at least one state, with preference for admission to the NYS bar.
• 3 years’ experience in a law firm or in-house setting
• Experience with commercial agreements and transactions within a health plan environment per the requirements noted above
• Knowledge and demonstrated understanding of TPAs, health plans (especially ASO/self-funded business) and related ERISA provisions
• Comfort with contract management and workflow tools and interest in using AI and other means to automate legal processes
• Knowledge of medical licensing and corporate practice of medicine statutes and regulatory and compliance frameworks

Skills & Behaviors:

• Communication - Strong, proven verbal and written communication skills, including the ability to convey complex or technical information in a manner that non-lawyers can understand and understand business objectives and translate into legal and regulatory requirements
• Strategic Thinking – Knack for sorting through clutter to find the best route, often by pulling up from the current complexity to identify patterns that guide future direction and allow one to narrow the options and articulate the options from which others can work backward.
• Business Acumen – A keenness and quickness in understanding and dealing with a business situation (risks and opportunities) in a manner that is likely to lead to a good outcome. Critical to this is an ability to think beyond their own function.
• Systems/Analytical Thinking – Demonstrates the ability to think fluidly and integrate information. Able to anticipate non-linear and non-obvious relationships. Often includes an ability to think holistically/conceptually – very powerful when accompanied by ability to communicate & clarify tactically.
• Flexibility/Working through Ambiguity – Tendency to be energized by new experiences/perspectives that test assumptions and thinking. Considers different points of view, sometimes with fragmented information, to arrive at practical, effective, actionable next steps.

Centivo Values:

• Resilient – This is wicked hard. There is no easy button for healthcare affordability. Luckily, the mission makes it worth it and sustains us when things are tough. Being resilient ensures we don’t give up.
• Uncommon - The status quo stinks so we had to go out and build something better. We know the healthcare system. It isn't working for members, employers, and providers. So we're building it from scratch, from the ground up. Our focus is on making things better for them while also improving clinical results - which is bold and uncommon.
• Positive – We care about each other. It takes energy to do hard stuff, build something better and to be resilient and unconventional while doing it. Because of that, we make sure we give kudos freely and feedback with care. When our tank gets low, a team member is there to be a source of new energy. We celebrate together. We are supportive, generous, humble, and positive.

Work Location:

• Remote, with a preference for a candidate within the WNY area

Who we are:

Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. Anchored around a primary care based ACO model, Centivo saves employers 15 to 30 percent compared to traditional insurance carriers. Employees also realize significant savings through our free primary care (including virtual), predictable copay and no-deductible benefit plan design. Centivo works with employers ranging in size from 51 employees to Fortune 500 companies. For more information, visit centivo.com.

Headquartered in Buffalo, NY with offices in New York City and Buffalo, Centivo is backed by leading healthcare and technology investors, including a recent round of investment from Morgan Health, a business unit of JPMorgan Chase & Co.