MHPAEA Lead Analyst

Contact Us
 
  • Remote
  • Wednesday, July 1st, 2020

Examination Resources, LLC

Job Description:

Mental Health Parity and Addiction Equity Act (MHPAEA) Lead Analyst

Summary

The MHPAEA Lead Analyst will perform special investigations and reviews of Health Insurance Companies with respect to compliance with MHPAEA as it relates to market reviews, internal policies and procedures, plan designs, and utilization review practices.  Our work is conducted on behalf of State and Federal regulatory entities. This position will serve as a subject matter expert for MHPAEA at our firm.

Key Requirements:                                   

  • Knowledge of the compliance requirements of the MHPAEA.
  • An understanding of how to perform comparative analysis of the application of MHPAEA requirements to health insurance plans with respect to financial requirements, quantitative  treatment limitations, fail first and step therapy requirements, network adequacy, utilization review, medical necessity review criteria, formulary design and other non-quantitative treatment limitations.
  • Experience in claims review and analysis.
  • Ability to analyze large amounts of data and understand how it applies to various marketplaces.
  • Familiarity with provider networking and contracting.
  • Understanding of data calls, claim trends, benefit structure, factors in plan design.
  • Background in performing market analysis desired.

Required Qualifications:

Expertise in Health lines of business, with an emphasis on the Affordable Care Act (ACA) and MHPAEA, as well as:

  • Three or more years of health insurance regulatory and compliance experience.
  • Exceptional written and oral communication skills.
  • Ability to adapt to frequently changing priorities.
  • Proficient in Microsoft Office (Word, Excel, PowerPoint, and Outlook) and Adobe Acrobat PDF.
  • College degree, or equivalent experience required.

Preferred Qualifications:

  • Insurance industry designations such as Fellow, Academy for Healthcare Management (FAHM).

Who Should Apply:

  • Regulatory Compliance Professionals
  • Health Insurance Industry Professionals and Consultants
  • Health Policy Analysts

Resume Submission Information:

Qualified candidates are invited to submit their resumes to theacook@examresources.net.

Please include:

  • Current resume.
  • A detailed letter of interest describing your skills and experience as they relate to the qualifications outlined in this job announcement.

The Right Fit

Join a dynamic group of insurance regulatory consultants with a mission of protecting consumers as it relates to mental health access and services. This role is remote but everything our team does is connected. This position will require an ability to work both very independently and as a team player; your communication style is curious, candid, and direct; you have a sense of urgency and will act promptly to respond to issues that arise and deadlines that change, and; you enjoy finding opportunities to create efficiencies to ensure the best delivery of services to our customers.

 

#insurance #ACA #MHPAEA #EIC #health #compliance #ER #NAIC #market conduct #remote