Compliance Program Consultant, Mental Health Parity

OverviewMedica 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.Key AccountabilitiesCompliance AdherencePartner 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 RequirementsDraft and update the Non-Quantitative Treatment Limitation Comparative Analysis for multiple states with a focus on clinical NQTLsAssists partners with implementation of new laws or regulations related to mental health parityAct as a resource for mental health parity questions and trainingAssists in the maintenance and implementation of department policies, procedures, and work processesRegulatory FilingsPrepare mental health parity filings for regulators in multiple states; coordinate submission of responses to questions/objections regarding the filingsParticipate in the product development process to ensure products comply with mental health parity prior to the products being filed with regulators for approvalAudit SupportParticipate in mental health parity-focused internal and external investigations, market conduct examinations, and audits (collectively, "audits")Respond to document requests for auditsConduct extensive audit researchPrepare comprehensive analyses and audit reportsMonitor & ReportConducts assigned special projects, provides program support, and performs reporting.Assists in the maintenance and implementation of department policies, procedures, and work processes.Required QualificationsBachelor's degree or equivalent experience in related field5 years of experience beyond degreePreferred QualificationsKnowledge of healthcare regulations and compliance program, or demonstrated logic and reasoning abilities and growth mindsetKnowledge of general health plan operations, technology delivery, and vendor management highly desirableDemonstrated knowledge of health care laws and regulations, including Medicare and Medicaid, or demonstrated ability to read and apply complex written materialHigh standard of ethics, responsibility, discipline, and professionalismExcellent conceptual thinking skills to analyze complex and sensitive issues and implement solutionsExcellent written and oral communication, presentation, problem-solving, and analytical skillsProven ability to communicate effectively with all levels of an organizationPMP or other project management certification is a plusDemonstrated ability to work well as a team; desire to contribute to a high-performing teamMust be able to appropriately challenge "conventional wisdom"Must be able to develop innovative solutions that balance legal and business needsMust demonstrate exceptional analytical strategic planning, issue identification and resolution skillsAbility to operate independently and handle multiple, complex projects with a high degree of initiative requiredDemonstrated ability to organize complex information and to effectively report information to leadershipDemonstrated Microsoft Office (Outlook, Word, Excel, PowerPoint, Teams) skills needed, SharePoint desirableDemonstrated learning mindsetThis 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 DisabilitiesThis 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. #J-18808-Ljbffr