Head of Legal & Compliance

Position Description

The Head of Legal & Compliance (Associate GC) is a key strategic partner to business and clinical leadership in directing efforts to manage company wide legal and compliance needs. 

Working with internal and external resources, they will ensure that Eleanor meets government regulations, laws and contractual obligations as they pertain to our care delivery; support growth objectives by advising on new market entry and contract negotiations; help build and reinforce a culture of impeccable ethics and commitment to doing things the right way; monitor external developments and implement policies to stay ahead of a fast-changing healthcare environment; and ensure Eleanor’s reputation and legal rights are protected.

Primary Responsibilities

• Compliance Program Development
  • Develop and initiate Compliance Program including Code of Conduct to ensure compliance with Corporate Practice of Medicine rules, Stark Laws, EKRA & Anti-kickback statutes, HIPAA, 42 CFR part 2, and other applicable SUD and privacy regulations
  • Monitor internal and external developments and update compliance program as required
  • Partner with Chief Security Officer to ensure effective data, systems, & physical security
  • Implements annual assessment process to identify key areas of compliance risk
  • Develop and implement compliance training, including introductory training for new employees, as well as ongoing training for employees and managers
  • Conduct annual reviews of the Compliance Program and report metrics and data sufficient to evaluate program effectiveness
    
• Compliance Leadership
  • Act as main point of contact for all company-wide compliance related matters
  • Provide leadership and exhibit awareness and understanding of ethical principles consistent with Eleanor’s Mission and Values
  • Communicate key issues to Eleanor’s Leadership team in a timely and effective manner
    
• Investigations and Issue Resolution
  • Establish and manage compliance Hotline
  • Conduct timely investigations of identified potential compliance issues and consult with leadership team, as necessary and appropriate
  • Coordinate and run quarterly Compliance Meetings
  • Counsel medical, clinical, and functional teams, create action plans for improvement, recommend disciplinary actions in coordination with People Operations
  • Attends to and de-escalates patient complaints and clinical issues
    
• New Market Entry
  • Review state and federal administrative and licensing rules to ensure Eleanor meets and maintains necessary requirements 
  • Collaborate with Quality team to put in place processes necessary secure CARF certification
    
• Funding and Transactional Support
  • Examine and create transactional materials and support due diligence for investment rounds and/or debt financing transactions
  • Examine and create transactional materials and support due diligence for acquisitions, joint ventures, and other partnerships to expand Eleanor’s activities
    
• Contract Strategy and Management 
  • Work with market operations, revenue operations, and business development/sales teams to identify key contract terms needed in agreements to achieve business goals
  • Review draft payer, provider and care partner agreements to understand operating obligations; engage key internal stakeholders to make recommendations to support Eleanor care and operating goals
  • Review complex payer, provider and care partner contracts to understand obligations; work with internal stakeholders to communicate obligations and establish approach to ensure compliance
    
• Medical Records Release
  • Establish Medical Records release policies and procedures to ensure timely and compliant response to provider, agency and court requests
  • Oversee and develop Medical Records release team to comply with relevant policies while meet service level agreement and other performance standards while driving continuous improvement
  • Build understanding and competency in effective medical records management among broader organization
    
• Outside Counsel Management
  • Source, vet, engage and manage outside counsel to ensure cost effective receipt of legal services when outside legal support is appropriate and/or necessary

Knowledge, Skill & Abilities

• Able to evaluate unclear/undefined legal and regulatory considerations in light of mission to transform mental health and SUD care while ensuring strong commitment to ethical and legal practices 
• Able to read and understand complicated contract requirements, regulations, and statutes 
• Good knowledge of legal requirements, procedures and compliance regulations including, but not limited to Part 521, HIPAA, 42 CFR part 2 and other applicable regulations related to running a healthcare practice focused on behavioral health and care of substance use disorders
• Excellent oral and written communication skills.
• Effective interacting with employees at all levels of the organization
• Able to juggle competing demands and priorities while meeting strict deadlines and maintaining strong attention to detail
• Analytical with strong project management and problem solving skills
• Comfortable leading in an environment of constant change and ambiguity
• Able to operate independently as an individual contributor and as organizational leader

Candidate Qualifications

• JD Degree Required
• Bachelor’s degree in Business, Healthcare Administration or related field required
• 5-10 years in progressive healthcare compliance roles required; multi-unit healthcare practice and telehealth experience (ideally in substance use treatment or other behavioral health) strongly preferred
• 3-5 years’ experience reviewing and understanding contracts strongly preferred
• Certification in Healthcare Compliance and Healthcare Privacy preferred
• Demonstrable experience in leadership, technical reading and writing, project management and problem-solving are essential
• Experience using Electronic Medical Records (EMR) systems strongly preferred

About Eleanor Health

Eleanor Health is the first outpatient addiction and mental health provider delivering convenient and comprehensive care through a value-based payment structure. Committed to health and wellbeing without judgment, Eleanor Health is focused on delivering whole-person, comprehensive care to transform the quality, delivery, and accessibility of care for people affected by addiction.

To date, Eleanor Health operates multiple clinics and a fully virtual model statewide across Louisiana, Massachusetts, New Jersey, North Carolina, Ohio, and Washington, delivering care through population and value-based partnerships with national and regional payors, employers, and other stakeholders.

If you are passionate about providing high quality, evidence based care for individuals with substance use disorder through an innovative practice, and about building a great business that makes a difference, Eleanor Health is an ideal opportunity for you. We seek highly skilled, motivated and compassionate individuals who take responsibility and adapt quickly to change to join our deeply committed and collaborative team.

Job Type: Full-time