Government Affairs Lead

Posted Yesterday
Be an Early Applicant
Hiring Remotely in New York City, NY, USA
In-Office or Remote
160K-220K Annually
Senior level
Healthtech • Kids + Family • Mobile • Telehealth
The Role
Lead state expansion by building relationships with legislators and agencies, shaping Medicaid strategy and program design, driving procurements from concept to contracting, supporting existing partnerships and renewals, tracking policy and legislation, managing external lobbying, and representing the company at conferences and statehouse meetings. Travel-heavy role to secure Medicaid and state partnerships and enable reimbursement strategies (SPAs/waivers) for peer support services.
Summary Generated by Built In
About Somethings

Somethings is building the first social wellness platform for teens — a place where a teen can form a real relationship with a mentor who gets them, sticks with them, and helps them get better.

25 Million teens in the U.S. are struggling with their mental health. Every one of the thousands of teens who download Somethings is struggling. Our job is to make sure they don’t just show up — they stay, connect with real humans who care deeply about them, and get the support that they need to thrive.

We’re backed by General Catalyst and world-class healthcare + consumer investors, and we’re growing like crazy — in 2025 we grew 1100%, raised our $15M Series A, and are on track to 5x in 2026.

If you want to be a part of the generationally defining company in mental health, welcome home.

Role Overview

We're looking for a Government Affairs Lead to lead Somethings into its next chapter of national expansion.

This is a builder role, not a traditional government affairs position. We are not looking for a passive lobbyist or a policy memo specialist. We are looking for someone who understands state government as a living system—where policy, people, budgets, and timing intersect—and who knows how to move that system forward.

Your north star is ambitious and concrete: expand Somethings into new states by building early relationships, shaping policy and program design, and converting those opportunities into meaningful Medicaid and state partnerships. You will be responsible for creating access before RFPs exist, helping states understand how Somethings fits into their priorities, and guiding opportunities from first conversation through procurement and contracting.

This role sits at the intersection of policy, relationships, and execution. You need to be comfortable discussing Medicaid strategy with a state director in the morning, aligning internal clinical and product teams in the afternoon, and traveling to a state capital or conference the next day to continue building trust.

Travel is not incidental to this role—it is core to it. Building real relationships with state leaders requires showing up, and you should expect to spend a significant portion of your time in person with agency leadership, partners, and stakeholders across the country.

Note: We expect this role to be 50-75% travel.

You will report to the Chief Commercial Officer and be embedded within the Sales squadron, while working closely with Clinical Operations, Product, and Operations. You will have significant autonomy, strong executive support, and a front-row seat to shaping how youth mental health care is delivered at a systems level.

Who You Are

You bring deep experience in Medicaid, behavioral health policy, or state government—whether from inside a state agency, a health plan, a health-tech company, or a policy organization that works closely with states. You understand how decisions are really made, including the informal dynamics that sit alongside formal processes.

You have owned end-to-end procurement processes, either within a state agency or from the vendor side, spanning budgeting through contracting.

You are a relationship builder with high emotional intelligence, able to earn trust quickly and communicate in a way that resonates with both the head and the heart. At the same time, you have a strong internal motor. You are someone who creates momentum, opens doors, and takes ownership of outcomes.

You thrive in ambiguity and high-ownership environments. You are motivated by mission, not as a slogan, but as a personal conviction. You want your work to matter, and you want to see its impact on real people’s lives.

What you’ll do

1. New State and City Expansion and Procurement
  • Identify and advance new state and city opportunities aligned with Something’s growth strategy

  • Build relationships with legislators, agencies, and budget offices to introduce and fund Something’s model

  • Advance Rural Health Transformation (RHT) initiatives to expand access in rural communities and new states

  • Lead states from concept through RFP, procurement, contracting, and go-live

2. Existing State Partnerships and Program Expansion
  • Collaborate with VP of Client Success to manage existing state partnerships

  • Identify opportunities inside the state to expand scope, populations served, or funding

  • Support renewals, amendments, and program scaling in collaboration with state stakeholders and legislatures. Ensure long-term funding sustainability by working with state legislatures.

3. Policy, Legislation, and Lobbying
  • Track and analyze local, state and federal legislation related to peer support, mental health services, AI, and age-of-consent laws

  • Manage and coordinate external lobbying firms

  • Draft letters of support and testimony for legislation of interest

4. Medicaid Strategy and Reimbursement
  • Lead efforts to establish peer support as a Medicaid-reimbursable service across states

  • Support SPA (State Plan Amendment) and/or waiver strategies to enable reimbursement

  • Monitor Medicaid policy changes and identify opportunities for expansion

5. Conferences, Travel, and External Engagement
  • Represent Something at national and state conferences, convenings, and industry events

  • Attend and participate in statehouse meetings, legislative hearings, and stakeholder briefings

How We Work

Somethings blends high performance with deep belonging. We speak the truth early, move quickly, and focus on outcomes instead of theatrics. We hold a high bar for craft, for integrity, and for the responsibility we have to the teens we serve. We are small, intense, collaborative, and all-in on building something that will outlast us.

The role will be a central part of this culture — someone who leads with clarity, operates with focus, and builds bridges inside and outside the company. You will be embedded in our Sales squadron and report to our Chief Commercial Officer. Collaboration partners may include Clinical Operations, Product, and Operations. You will have significant autonomy, the trust of the leadership team, and a front-row seat to building one of the most important mental health companies of this decade.

Work Environment & Compensation
  • This is a full-time position in person in our NYC office or remote in the US.

  • We have an output driven culture and provide lots of flexibility throughout the week as needed.

What We Offer
  • 💰 The annual salary range for this position is $160-220k

  • 📈 Significant equity compensation, reflecting your foundational role and impact.

  • 🏥 Comprehensive health insurance coverage.

  • 🎯 Significant work ownership and autonomy

  • 🎉 Unlimited days off.

Equal Opportunity Statement

At Somethings, we're committed to building a workplace where diversity is not just welcomed, it's celebrated. We believe that innovation thrives on teams where everyone can be their authentic selves, bringing unique perspectives and backgrounds to the table. We are proud to be an Equal Opportunity Employer. This means all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. Our commitment to inclusivity is woven into the fabric of our corporate culture, ensuring everyone has the opportunity to succeed, learn, and grow with us.

Skills Required

  • Deep experience in Medicaid, behavioral health policy, or state government
  • Owned end-to-end procurement processes from budgeting through contracting and go-live
  • Proven ability to build and maintain relationships with legislators, state agencies, and budget offices
  • Experience establishing Medicaid reimbursement strategies, including SPA and waiver strategies for peer support services
  • Experience managing existing state partnerships, renewals, amendments, and program scaling
  • Experience managing and coordinating external lobbying firms and drafting testimony or letters of support
  • Willingness and ability to travel extensively (expected 50-75% travel)
  • Strong cross-functional collaboration with clinical, product, and operations teams
  • High emotional intelligence and strong relationship-building and communication skills
Am I A Good Fit?
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The Company
69 Employees
Year Founded: 2021

What We Do

Somethings is a New York–based digital mental health and wellness platform that connects teenagers with trained Certified Peer Specialist mentors via a mobile app for asynchronous chat and calls. The service—supervised by clinicians and partnered with schools and organizations—offers non‑clinical emotional support to help teens manage anxiety, depression, social challenges and loneliness, complementing traditional care.

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