Regulatory Operations - Mental Health Parity Analyst III

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

Applicants for this job have the flexibility to work remote from home anywhere in the Continental United States.

Position Purpose: Performs and oversees the development of Mental Health Parity related filings and/or filing material for Marketplace products in the commercial markets. Performs and/or assists with regulatory research and issue advocacy in relation to Mental Health Parity policy positioning. Guide special projects.

• 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. Provides recommendations to the business based on analysis/interpretation.
• Subject Matter Expert for department functions and regulatory interpretation related to Mental Health Parity for the commercial product. Attends cross-functional meetings as department lead and shares positioning within meetings. Responsibility for understanding regulations and business needs for multiple states, as well as federal regulations pertaining to the commercial health insurance market.
• 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.

Education/Experience:

• Bachelor's Degree in business, Communications, Health Care, Political Science/Pre-Law or equivalent experience required. Master's Degree in a related field or Juris Prudence preferred
• 4+ years experience in health insurance, legal, or compliance ore related area required.
• Experience in commercial health insurance and/or behavioral health managed care preferred.
• Experience developing and/or auditing policy documentation and/or QHP filing templates preferred.
• Knowledge of Mental Health Parity law(s) and SERFF preferred.

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.  Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act