Compliance Program Consultant, Mental Health Parity

Description

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.

We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.

This position provides mental health parity compliance support to all lines of Medica's business. This role partners with business units, particularly those aligned under Health Services, to ensure compliance with applicable state and federal mental health parity regulations, including the requirements to ensure financial requirements, quantitative treatment limitations, and non-quantitative treatment limitations are designed and applied no more stringently for mental health / substance use services than medical / surgical services. The consultant also contributes to enterprise risk assessments, facilitates the implementation of regulatory changes pertaining to mental health parity with external partners, and leads or supports other compliance activities such as federal regulatory investigations and state market conduct exams. Operating at a senior professional level, this role exercises decision-making authority and serves as a key resource in navigating complex compliance projects.

The individual will be responsible to maintain and review regulatory documentation necessary to maintain corporate standards which includes maintenance and implementation of department policies, procedures, and work processes. This individual will work closely with other members of the Mental Health Parity (MHP) Team and will partner with business leads and subject matter experts across the organization to establish and maintain the tenets of the mental health parity program and execute related activities accurately and timely. This position will serve as the primary point of contact for Health Services to provide guidance to internal partners and will assist with mental health parity efforts of the compliance program. Performs other duties as assigned.

Key Accountabilities

Compliance Adherence

• Partner with internal business areas and external vendors to ensure compliance with mental health parity's requirements for Quantitative Treatment Limitations, Non-Quantitative Treatment Limitations, and Financial Requirements
• Draft and update the Non-Quantitative Treatment Limitation Comparative Analysis for multiple states with a focus on clinical NQTLs
• Assists partners with implementation of new laws or regulations related to mental health parity
• Act as a resource for mental health parity questions and training
• Assists in the maintenance and implementation of department policies, procedures, and work processes

Regulatory Filings

Audit Support

Monitor & Report

Required Qualifications

Preferred Qualifications

This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations : Minnetonka, MN, or Madison, WI.

The full salary grade for this position is $77,100 - $132,200. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $77,100 - $115,710. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and / or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities

This employer is required to notify all applicants of their rights pursuant to federal employment laws.

For further information, please review the Know Your Rights notice from the Department of Labor.