Compliance Program Consultant, Mental Health Parity

Compliance Program Consultant, Mental Health Parity

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.

The Compliance Program Consultant, Mental Health Parity administers an assigned Compliance Program by providing mental health parity subject matter expertise and consultation to ensure compliance with State & Federal law. This role is responsible for designing and incorporating processes and internal regulations to ensure compliance standards within the organization as part of Medica's Legal team. This Compliance Program Consultant partners with internal business leaders and external vendors to ensure compliance with the Quantitative Treatment Limitations, Non-Quantitative Treatment Limitations, and Financial Requirements as a specialist and expert in mental health parity compliance.

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
  • Assist partners with implementation of new laws or regulations related to mental health parity
  • Act as a resource for mental health parity questions and training
• Regulatory Filings
  • Prepare mental health parity filings for regulators in multiple states; coordinate submission of responses to questions/objections regarding the filings
  • Participate in the product development process to ensure products comply with mental health parity prior to the products being filed with regulators for approval
• Support
  • Participate in mental health parity-focused internal and external investigations, market conduct examinations, and audits (collectively, "audits")
  • Respond to document requests for audits, conduct extensive audit research and prepare comprehensive analyses and audit reports
• Monitor & Report
  • Conduct assigned special projects, provides program support, and performs reporting
  • Assist in the maintenance and implementation of department policies, procedures, and work processes

Required Qualifications

• Bachelor's degree or equivalent experience in related field
• 5+ years of work experience beyond degree with a specialty in mental health parity, experience in a clinical setting and/or healthcare compliance experience

Preferred Qualifications

• Demonstrable skill in working collaboratively with cross-functional teams
• Proven ability to work independently
• Strong professional acumen

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 $78,700 - $134,900. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $78,700 - $118,020. 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.

Internal Applicants: We're excited about your interest in growing your career at Medica! To be eligible to apply for internal opportunities, employees must have been in their current role for at least one year.

Recruiter: Cameryn Bailey

Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.

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.