About Centivo

Centivo is a new type of health plan anchored around leading providers of value-based care. Centivo saves self-funded employers 15 percent or more compared to traditional insurance carriers and is easy to use for employers and employees.

Centivo’s mission is to bring affordable, high quality healthcare to the millions of working Americans who struggle to pay their healthcare bills. With Centivo, employers can offer their employees affordable and predictable costs, a high-tech member experience, exceptional service, and a range of benefit options including both proprietary primary care-centered ACO models as well as traditional networks. An alternative to traditional insurance carriers or third-party administrators (TPAs), Centivo builds proprietary networks and offers all of the technology and service to fully administer health benefits.

Employers get a benefits solution that saves them money, provides full transparency into costs and data, and allows them to offer a range of benefit options to meet the needs of a diverse employee population. Employees and their families get quality care at affordable and predictable costs, a partner to help them navigate the healthcare system, and a great member experience.

With offices in Buffalo, NY, Denver, CO, New York City and Stamford, CT, Centivo is backed by leading investors including B Capital Group, Bain Capital Ventures, Bessemer Venture Partners, Company Ventures, Define Ventures, F-Prime Capital, HarbourVest Partners, Ingleside Investors, Maverick Ventures, Nassau Street Ventures (an AVG fund), Oxeon Investments, and Rand Capital.

Summary of role:

As Centivo has grown, we are looking for someone to serve in an inaugural in-house counsel position. The role requires knowledge of and experience with federal and state laws and regulations unique to the health care industry, and in particular, self-insured/self-funded health plans.

Reporting to our Chief Business 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 build an in-counsel in function and related processes. The initial focus will be client and vendor contracting, support for the launch of a new virtual primary care business, and other legal and regulatory responsibilities.

Responsibilities Include:

• Drafting, negotiating, redlining, and finalizing the following agreements:
• Employer administrative services agreements (ASAs)
• Channel partnership joint-marketing agreements
• Vendor agreements (MSAs)
• Data security agreements, e.g., Business Associate Agreements (BAAs) Data Transfer/Utilization Agreements (DUAs)
• Supporting regulatory compliance matters for the company, including medical licensing, adherence to corporate practice of medicine statutes, and individual producer and TPA licensing
• Overseeing and coordinating work with outside counsel and licensing consultants
• Project management of contract inventory and oversight for executed agreements (file management, renewal tracking, etc.)
• Providing advice and counsel to our Chief People Officer (an attorney admitted to practice in NYS) on employment matters as necessary.

Work Location:

• We were hoping to have someone assigned to our corporate headquarters in Buffalo, NY who could work from the office 2+ days per week, but have opened the search up to 100% remote candidates

Required Skills and Abilities:

• Knowledge and demonstrated understanding of TPAs, health plans (especially ASO business) and related ERISA provisions
• Knowledge of medical licensing and corporate practice of medicine statutes and regulatory and compliance frameworks
• Knowledge of provider networks and reference-based pricing practices
• Prioritize and organize own work to meet deadlines
• Excellent verbal and written communication skills; ability to convey complex or technical information in a manner that non-lawyers can understand, as well as ability to understand and business objectives and translate into legal and regulatory requirements and activities

Education, Experience, and 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.
• 6+ years of experience in a law firm or in-house setting (lesser experience would be considered at an Associate General Counsel level)
• Experience with commercial agreements and transactions within a health plan environment per the requirements noted above