[Remote] Mental Health Parity Compliance Analyst
Note: The job is a remote job and is open to candidates in USA. 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.
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
Skills
- 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
- 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
Company Overview
- Wellfleet is an insurance company that provides accident and health insurance. It was founded in 1993, and is headquartered in Springfield, Massachusetts, USA, with a workforce of 201-500 employees. Its website is https://wellfleetinsurance.com.
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