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Behavioral Health Parity Compliance Manager

Company: MetroPlus Health Plan
Location: New Haven
Posted on: May 5, 2021

Job Description:

Job Description About NYC Health + Hospitals MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus' network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life. Position Overview The Behavioral Health Parity Compliance Manager, reporting to the Senior Director of Compliance Operations, plays an integral role in the oversight and management of our Behavioral Health Parity Compliance Program. 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 Compliance risk analysis and work plan. Ensuring the applicable Behavioral Health Parity Compliance Program and related training are accurate and updated. Job Description * Assist in the creation and maintenance of the Behavioral Health Parity Compliance Program document, updating descriptions as needed and ensures proper approval is attained from the Compliance Committee. * Supporting the annual Plan risk assessment, collaborating with the Compliance team, to assist the enterprise in identifying areas with potential behavioral ealth compliance issues. * Supports 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 Plan's behavioral health parity compliance program and its' related activities. * Plans, organizes, and manages the day-to-day operations of this area within Compliance. * Participating in Internal Compliance Committee Meetings and Behavioral Health Operational Committee; collaborating with all necessary areas to prepare materials and additions to any presentation. Collecting and updating of materials for the Audit and Compliance Subcommittee of the Board of Directors. * Tracks related due dates and provides support to business areas completing deliverables relating to guidance. * Plays critical role in the management 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. * Lead business areas in preparing for disclosure of non-compliance to regulatory bodies, as appropriate. * Assist business areas in creating and updating monitoring metrics to assess continued compliance with regulatory requirements. * Ensures open lines of communication, both internally and externally, so any reports of potential noncompliance are received and investigated. * Review and update behavioral health parity related training, as needed. * Other duties as assigned or requested Minimum Qualifications * Bachelor's Degree or equivalent work experience. * 3-4 years' experience in compliance, regulatory affairs, or government affairs, preferably with a background in mental health requirements. * 3-4 year's experience with Mental Health Parity as a health care responsibility, preferred. * Prior successful experience working with regulators on compliance audits, reporting and other matters. * Experience managing complicated projects, keeping track of details, and staging work to deliver projects on time. * Proven ability to articulate regulatory requirements to business and technical staff to capture information and achieve results. * Experience with developing reporting and metric. Licensure and/or Certification Preferred * CHC, CCEP Professional Competencies * Broad-based in-depth knowledge of the managed care industry, including: strategic compliance planning, regulatory concerns, compliance requirements, and corporate integrity principles. The ability to comprehend and interpret regulatory, legislative, and contractual mandates. * Experience with managed care, federal and/or state regulations, quality improvement and compliance oversight. * High-level of skill in leading

Keywords: MetroPlus Health Plan, New Haven , Behavioral Health Parity Compliance Manager, Executive , New Haven, Connecticut

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