Corporate Counsel - Healthcare Regulatory, Medicare New York, NY - One Medical

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One Medical is a primary care solution challenging the industry status quo by making quality care more affordable, accessible and enjoyable. Our seamless in-office and 24/7 virtual care services, on-site labs, and programs for preventive care, chronic care management, common illnesses and mental health concerns have been delighting people for the past fifteen years.

As One Medical continues to expand and transform the primary care experience, we’re looking for a Healthcare Regulatory Counsel to join our Legal team. This role primarily involves supporting Medicare, Medicare Advantage, and other value-based care business initiatives as well as advising on general healthcare regulatory matters.

You will have experience working with government programs and payors, including drafting and reviewing agreements, advising on fraud waste and abuse laws such as the Anti-kickback Statute, Civil Monetary Penalties Law, False Claims Act, and Stark law. You will effectively manage complex provider transactions, including shared savings/gainsharing contracts, capitation, and other at-risk arrangements. Additionally, you will build tools (e.g., contracting playbooks) and processes to streamline transactions, working across business teams and developing trusting relationships with key stakeholders.

In addition to healthcare regulatory knowledge, success in this role will require pragmatism and sound decision making. You are skilled at collaborating with cross-functional stakeholders to drive results. You will quickly establish a comprehensive understanding of our business and provide actionable and practical advice based on sophisticated interpretation of facts and laws. You are responsive to clients and colleagues, and are aware that bias for action is key to our success.

Last, at One Medical, we expect all team members to live our DNA, which is to be human-centered, team-based, intellectually curious, with unbounded thinking and driven to excel.

Responsibilities:

• Advising, structuring, negotiating and drafting government payor agreements, partnerships and other healthcare arrangements.
• Support internal business stakeholders in evaluating and developing business opportunities for healthcare regulatory implications.
• Analyze healthcare regulatory issues, including those related to government payors, value-based care models and strategic partnerships.
• Proactively identify risk and formulate strategic approaches to optimize business performance.
• Partner with Government Affairs, Compliance, and other internal business stakeholders on policy matters and provide support related to government agency interactions, including inquiries and audits.
• Assist day-to-day operations and ad hoc projects as needs arise.

Qualifications:

• J.D. from an ABA accredited law school and an active member in good standing with the Bar in any state.
• 5+ years of legal practice experience.
• 3+ years of healthcare regulatory legal work, with a strong preference for at least 2 years working in an in-house capacity in a health system, health tech organization, health plan or healthcare related government agency.
• Familiarity with Medicare and Medicare Advantage, federal and state Fraud, Waste and Abuse Laws; demonstrated knowledge of value-based care, health plans, CMS policies and guidelines, including those related to marketing; experience relating to broker/agent laws; billing and coding compliance.
• Strong analytical ability, including the inclination to be open minded when presented with new or additional information.
• Solid EQ and sound judgment on when and how to surface and escalate issues.
• Commitment to a service-based ethos to serve our clients and our members.
• Excellent written and verbal communication skills.

Preferred:

• A mixture of law firm and in-house experience preferred.
• Preference for working knowledge of telehealth regulations, direct primary care, state and federal risk-bearing organization laws, federal healthcare reform, HIPAA, and ERISA issues.

This is a full-time role based in New York City, San Francisco, Seattle or Washington, D.C. requiring on-site presence 5 days per week (Mon-Fri).

One Medical is an equal opportunity employer and encourages all applicants from every background and life experience.

One Medical is committed to fair and equitable compensation practices.

Our compensation reflects the cost of labor across several US geographic markets. The base pay for this position ranges from $138,500/year in our lowest geographic market up to $229,000/year in our highest geographic market. Pay is based on a number of factors including market location and may vary depending on job-related knowledge, skills, and experience.

One Medical participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.