Compliance Lead, Mental Health Parity

Humana

1d • $115,200 - $158,400 • Remote

About The Position

The Compliance Lead; Mental Health Parity ensures regulatory and contractual compliance with Mental Health Parity both at a federal and state-level. Primarily, they ensure compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA) for Humana’s Medicaid market. Additionally, the Lead supports other products within Humana’s enterprise.
The Lead analyzes business requirements, provides research and regulatory interpretation, and advises internal business units and external business partners in delivering results in a manner that minimizes risk exposure for the Company across our Medicaid segments and enterprise. The lead is responsible for completing risk assessments, creating annual work plans to audit and monitor Humana's compliance with MHPAEA and other relevant federal and state laws. In addition, the Lead reviews and identifies data and analytics to identify and mitigate compliance concerns. The compliance lead serves as an expert to the business around questions related to MHPAEA compliance and provides regulatory guidance on remedial actions to strengthen compliance controls.

Requirements

• Bachelor's Degree
• 7 or more years of legal or compliance experience
• 2 or more years of project leadership experience

Nice To Haves

• MBA and/or JD
• Knowledge of healthcare operations and healthcare audits
• Knowledge/understanding of MHPAEA and other Mental Health Parity regulations
• Knowledge/understanding of healthcare laws and regulations
• Demonstrated ability to prioritize and lead individuals in running large-scale, highly visible projects
• Demonstrated ability to think strategically and influence business partners and leadership

Responsibilities

• Develop strategy and provide on-going oversight and monitoring of Humana business areas involved with MHPAEA compliance, as well as other enterprise compliance needs, to ensure full compliance and minimize risk for the Enterprise
• Complete risk assessments and create annual work plans to audit and monitor operational performance
• Understanding operational processes and identifying areas of risk mitigation opportunities
• Interpret and define regulatory and contractual requirements to be implemented by appropriate Humana internal business areas and/or external business partners
• Communicate with and present to outside regulators
• Oversee and perform the auditing and monitoring of Humana business areas involved with MHPAEA compliance and Wellness business and report to RC leadership top risks, remediation plans and other information as appropriate
• Oversee submission of reports, filings, and attestations to state and federal regulators
• Document issues and opportunities (IOPs) in Enterprise Solution Point (ESP/Archer) as needed
• Work across Humana Business Operations to enhance data analytics and operational improvement efforts
• Perform assessments, develop action plans, and provide guidance to Humana business areas
• Influence enterprise and department strategy

Benefits

• medical
• dental
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Senior