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Wellfleet · 6 days ago

Mental Health Parity Compliance Analyst

United States

Full-time

Remote

Mid Level

$85K/yr - $95K/yr

3+ years exp

Wellfleet is a Berkshire Hathaway company that provides customer-centric accident and health insurance services. They are seeking an experienced Mental Health Parity Compliance Analyst to assist in ensuring compliance with federal and state mental health parity laws while leading various initiatives and supporting the Legal team.

Employee BenefitsHealth CareInsuranceInsurTechLife Insurance

Responsibilities

Monitor and interpret federal and state regulations related to mental health parity (MHPAEA, ACA, state mandates)

Conduct compliance reviews of benefit designs, non-quantitative treatment limitations (NQTLs), and utilization management processes to ensure parity between MH/SUD and medical/surgical benefits

Project manage MHP filings for multiple states, support the preparation of NQTL/filing templates and submission of filings

Perform review of the MHP state filings prior to submission

Coordinate and draft response to address regulatory inquiries/objections

Partner with Product, Legal, Clinical, and Operations teams to implement and integrate parity requirements into plan designs and processes

Maintain MHP program policies, procedures, and training documents

Assist with development and execution of Wellfleet’s MHP Program (e.g., driving the MHP initiates, monitoring of various MHP activities, oversight of the MHP program, etc.)

Conduct monitoring activities to ensure compliance with MHP program infrastructure

Monitor progress of MHP activities and report on progress and impact of parity to internal and external stakeholders, etc.)

Identify potential areas of improvements and develop strategies to address them

Support SMEs in root cause analysis and corrective action plan when non-compliance is identified

Stay current on industry best practices and trends in MHP and ensure Wellfleet initiatives are aligned

Qualification

Mental Health Parity lawsHealth insurance complianceProject managementNon-quantitative treatment limitationsHealthcare laws interpretationMS Office SuiteCritical thinkingCommunicationOrganizational skillsSelf-motivated

Required

Bachelor's degree in related field and a minimum of 3+ years' experience in health insurance compliance, regulatory affairs, or related legal/clinical field or equivalent combination of education and experience

Knowledge of MHPAEA, ACA, and applicable state and federal mental health parity laws/requirements

Demonstrated experience in conducting filings of mental health parity with experience with non-quantitative treatment limitations (NQTL)

Strong understanding and interpretation of key healthcare laws and regulations

Demonstrated project management skills utilizing conceptual thinking to analyze complex, sensitive issues and implement solutions

Possess critical thinking skills with proven ability to identify and analyze complex problems and review related information to develop and evaluate options to implement solutions

Ability to adapt and pivot when presented with new information or circumstances

Excellent verbal, written and interpersonal communication skills

Excellent organizational skills with the ability to efficiently manage multiple assignments and prioritize tasks in a fast-paced environment to meet deadlines

Self-motivated with the ability to work independently, with peers and collaboratively in a cross functional environment

Strong work ethic, taking ownership of work to achieve performance expectations with a commitment to integrity and compliance

Proficiency in MS Office Suite, specifically Outlook, Excel, PowerPoint, and Word

Available and able to travel for work approximately 3-4 trips per year

Preferred

Experience with health plan operations, utilization management, or benefit design

Benefits

Life, health and dental, vision, 401K retirement plan, short- and long-term disability coverage, flexible/dependent care spending account, tuition reimbursement