PA Health & Wellness · 1 day ago
Regulatory Operations - Mental Health Parity Analyst III
California, United States
Full-time
Onsite
Mid Level
$70K/yr - $126K/yr
4+ years expPA Health & Wellness is a diversified, national organization transforming the health of communities. The role involves overseeing the development of Mental Health Parity filings, conducting regulatory research, and guiding special projects related to Mental Health Parity policy positioning.
FitnessHealth CareWellness
Responsibilities
Analyzes and interprets proposed or enacted legislation and/or regulations in relation to federal MHPAEA law and/or state Mental Health Parity law for business impacts and subsequently communicates impacts to the business and/or impacted departments in assigned high risk states for commercial product
Subject Matter Expert for department functions and regulatory interpretation related to Mental Health Parity for the commercial product
Oversee the preparation and/or development of Mental Health Parity Nonquantitative Treatment Limitations (NQTL) Comparative Analyses documentation for internal business needs and/or for formal regulatory reporting deadlines for Marketplace products for assigned high risk states
Creates and revises federal MHPAEA law and/or state Mental Health Parity law related filing documentation (including Nonquantitative Treatment Limitation (NQTL) Comparative Analyses, Quantitative Treatment Limitation (QTL) Testing Templates, and Qualified Health Plan (QHP) regulatory filing documentation related to federal MHPAEA law and/or state Mental Health Parity law, projects, and communications for assigned high risk states
Audits documents for accuracy and alignment with regulations and internal business strategies
Lead initiatives related to these activities
Creates and performs quality and accuracy audits on Quantitative Treatment Limitation (QTL) Testing Templates, and additional Qualified Health Plan (QHP) documentation related to Mental Health Parity, for assigned high risk states
Performs data entry into QTL Source of Truth and audits data inputs
Data inputs are used to demonstrate compliance to regulators
Leads cross-functional meetings, building strong relationships, to collaborate on creation of Mental Health Parity documentation and policy positioning and advocacy
Assists in supporting successful relationship with regulatory agencies (Department of Insurance (state DOI) and Centers for Medicare & Medicaid Services (CMS))
Independently drafts responses to external requests for information required by the organization for its regulatory filings and/or for policy advocacy specific to federal MHPAEA law and/or state Mental Health Parity law
Leads onboarding of new employees and training of analysts on essential job duties
Responsible for revising training materials specific to workstream responsibilities and/or processes
Responsible for maintaining critical internal filing trackers and other reference materials to complete federal MHPAEA law and/or Mental Health Parity law related filing submissions; Identifies and leads risk reduction initiatives related to decrease YOY objection totals specific to federal MHPAEA and/or state Mental Health Parity law
Develop and spearhead new projects with a focus on communications, workflow, and quality initiatives
Oversees maintenance and implementation of department policies, procedures, and work processes specific to workstream responsibilities and/or processes
May attend external and/or virtual conferences and seminars to evaluate industry trends
Performs other duties as assigned
Complies with all policies and standards
Qualification
Required
Bachelor's Degree in business, Communications, Health Care, Political Science/Pre-Law or equivalent experience
4+ years experience in health insurance, legal, or compliance or related area
Preferred
Master's Degree in a related field or Juris Prudence
Experience in commercial health insurance and/or behavioral health managed care
Experience developing and/or auditing policy documentation and/or QHP filing templates
Knowledge of Mental Health Parity law(s) and SERFF
Benefits
Competitive pay
Health insurance
401K and stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Company
PA Health & Wellness
Established to deliver quality healthcare in the state of Pennsylvania through local, regional and community-based resources, PA Health & Wellness is a Managed Care Organization and subsidiary of Centene Corporation (Centene).
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Justin Davis
President and Chief Executive Officer
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