Mental Health Parity Coordinator

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Facilitate and assist in ensuring enterprise compliance with MHPAEA and applicable state mental health parity regulations.

• Aid in performing and sustaining Non Quantitative Treatment Limitation (NQTL) analyses, which include documentation, comparative evaluations, and readiness for regulatory compliance.

• Oversee benefit designs, utilization management practices, provider network standards, reimbursement methods, and administrative processes to ensure parity compliance.

• Collaborate with internal teams and delegated vendors to collect necessary data, policies, procedures, and evidence for parity assessments.

• Monitor regulatory guidance, enforcement activities, and new parity requirements; assist in implementing necessary changes.

• Support regulatory examinations, audits, and information requests pertaining to mental health parity.

• Record findings, risks, mitigation strategies, and corrective measures; keep parity files organized and ready for audits.

• Coordinate issue resolution and follow up with internal stakeholders to ensure prompt remediation of identified gaps.

• Provide training and guidance to internal teams on mental health parity requirements and compliance expectations.

• Engage in cross-functional workgroups and compliance committees that focus on behavioral health, benefits, and regulatory oversight.

• Assist with ongoing compliance reporting and updates for leadership as needed.

• Ensure accurate documentation in line with company policies and regulatory standards.

• Meet the performance expectations set by the department and the company.

• Perform additional duties as assigned.

• Adhere to PacificSource's privacy policy and HIPAA regulations regarding the confidentiality and security of protected health information.

• Work in a general office environment equipped with ergonomically designed furniture.

• Travel is required approximately 10% of the time.

⛳️ Requirements

• A minimum of 3 years of experience in healthcare compliance, behavioral health, utilization management, regulatory analysis, the health insurance industry, or another medical environment.

• A Bachelor's degree in healthcare administration, public health, business, legal studies, or a related discipline is required.

• An Associate’s degree and 2 years of relevant experience, or a high school diploma and 4 years of relevant experience, may be considered in addition to the required minimum years of work experience.

• Strong knowledge of health insurance operations and principles of regulatory compliance.

• Capability to analyze policies, processes, and comparative data to pinpoint compliance risks.

• Excellent organizational, documentation, and attention to detail abilities.

• Strong written and verbal communication skills.

• Ability to handle multiple priorities, maintain confidentiality, and work independently with minimal supervision.

• Proficiency in reading and comprehending written and spoken English.

• Ability to communicate clearly and effectively.

• Capability to adhere to privacy policies and HIPAA regulations regarding confidentiality and security of protected health information.

• Advanced education or certifications related to compliance are preferred.

• Experience with mental health parity, behavioral health operations, Medicaid, Medicare, or administration of commercial health plans is preferred.

• Familiarity with regulatory audits, document reviews, and cross-functional coordination is preferred.

🏝️ Benefits

• Equal opportunity employment.

• Work-from-home flexibility.

• Ergonomically designed equipment.

• Approximately 10% travel opportunity.

• At-will employment.