Behavioral Health Parity Compliance Lead

Profile

Description

The Behavioral Health Parity Compliance Lead will play an integral role in the oversight and management of our Mental Health Parity Compliance Program.

Responsibilities

This role is responsible for monitoring all related behavioral health regulatory guidance and implementations, supporting the organization with corrective actions and regulatory disclosures, contributing to the annual risk analysis and work plans. In addition to ensuring that the Humana Healthy Horizons Mental Health Parity Compliance Program and related training are accurate and updated.

Duties to include:

Assist in the creation and maintenance of the Mental Health Parity Compliance Program document, updating descriptions as needed and ensuring proper approvals are attained

Develop and maintain MHP reporting and metrics.

Support risk assessment activities, including collaborating with the Compliance teams, to assist in identifying areas with potential behavioral health compliance issues.

Support the completion and presentation of the Annual Compliance Work Plan, overseeing completion of auditing and monitoring projects identified within the Work Plan that impact behavioral health.

Developing, initiating, maintaining, and revising policies and procedures for the general operation of the Humana Medicaid MHP compliance program and related activities.

Tracks related due dates and provides support to business areas completing deliverables relating to guidance.

Assist with the creation of behavioral health annual guidance documents and submissions, such as the Mental Health Parity and Addition Equity Act submissions.

Assisting in the identification and resolution of operational challenges and issues and monitors the implementation of any corrective action plans issued as a result.

Upon identification of non-compliance, provide support to business areas in conducting a root cause analysis and corrective actions, including guidance on methodology, identification of relevant regulatory requirements and any regulatory compliance context, and Compliance review.

Review and update behavioral health parity related training, as needed.

Lead business areas in preparing for disclosure of non-compliance to regulatory bodies, as appropriate.

Other duties as assigned or requested

Required Qualifications

Bachelor's Degree or equivalent work experience.

Experience with managed care, federal and/or state regulations, quality improvement and compliance oversight.

Prior experience working with compliance audits, reporting and other matters.

The ability to comprehend and interpret regulatory, legislative, and contractual mandates.

5 years of experience in compliance, regulatory affairs, or government affairs, preferably with a background in mental health requirements.

2 years of project leadership experience

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Advanced experience with building, collecting, validating, and communicating large sets of data

Preferred Qualifications

CHC, CCEP

Advanced graduate degree

5 years of experience with Mental Health Parity

Project Management Professional (PMP) certification

Six Sigma certification

Experience in an audit or compliance role

Additional Information

This position is open to work remote. Must be able to accommodate working hours of 8:30 - 5:30 est.

Work at Home/Remote Requirements

Must ensure designated work area is free from distractions during work hours and virtual meetings

Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance of is required

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com