Healthcare Nondiscrimination Program Manager

Wellmark Blue Cross and Blue Shield; Des Moines (IA); On-site; USD 60,000 - 100,000; Full time

Job summary

Join a forward-thinking organization dedicated to the well-being of its members. This role focuses on managing compliance with nondiscrimination laws and mental health parity requirements. As a key player, you will coordinate training, handle grievances, and ensure adherence to federal regulations. Your expertise will foster collaboration across departments, enhancing the organization's commitment to equity in healthcare. If you are passionate about making a difference and thrive in a dynamic environment, this is the perfect opportunity for you to contribute to meaningful change.

Qualifications

• 4+ years in regulatory compliance with strong communication skills.
• Experience with ACA Section 1557 and mental health parity laws.

Responsibilities

• Manage nondiscrimination program and coordinate compliance efforts.
• Conduct audits and represent the company in regulatory matters.

Skills

Regulatory compliance

Grievance resolution

Policy development

Analytical skills

Communication skills

Interpersonal skills

Critical thinking

Detail-oriented

Problem-solving

Teamwork

Education

Bachelor’s degree

Juris Doctor (JD)

Tools

Microsoft Office Suite

Job description

• Full-time
• Department: Legal | Compliance | Audit | Risk
• Pay Grade: 23

Company Description

Why Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today!

Learn more about our unique benefit offerings here.

Want to know more? You can learn about life at Wellmark here.

Job Description

Wellmark is looking for a passionate individual to manage our nondiscrimination program. This individual will act as Wellmark’s designated Civil Rights Coordinator responsible for serving as a subject matter expert and coordinating compliance with provisions of the Affordable Care Act’s (ACA) Section 1557, Section 504, and other federal and state nondiscrimination laws which prohibit discrimination in health program operations. This also includes receiving and responding to nondiscrimination grievances, recordkeeping, maintaining Notice of Nondiscrimination and Notice of Accessibility, coordinating compliance with Wellmark’s language access procedures, effective communication procedures, reasonable modification procedures, and coordinating required employee trainings. In addition, they will coordinate compliance support of mental health parity requirements by serving as a subject matter expert of state and federal regulatory requirements, providing compliance support in designing and maintaining compliant policies and procedures, and coordinating compliance oversight procedures, while actively building relationships throughout the organization. They will also represent Wellmark on internal and external audits of nondiscrimination and mental health parity requirements, and actively participate in BCBSA workgroups.

The ideal candidate for this role is a detail-oriented and passionate compliance professional with expertise in federal and state nondiscrimination laws, including ACA Section 1557 and Section 504. They have a strong background in regulatory compliance, grievance resolution, and policy development related to nondiscrimination and mental health parity. With excellent communication and relationship-building skills, they are confident in representing Wellmark in audits, collaborating with internal and external stakeholders, and actively participating in industry workgroups to stay ahead of evolving regulations.

Qualifications

Required:

• Bachelor’s degree or direct and applicable work experience.
• 4+ years’ experience in a regulatory, risk, or compliance role, including 4+ years’ experience reading, interpreting, understanding, and communicating regulations. Ability to comprehend complex federal regulations and articulate to internal stakeholders. OR
• Juris Doctor (JD) and 2+ years’ experience in a regulatory, risk, or compliance role, including 2+ years’ experience reading, interpreting, understanding, and communicating regulations.
• Ability to comprehend complex federal regulations and articulate to internal stakeholders.
• Experience developing and maintaining effective relationships and building trust with others in order to encourage and support communication and teamwork.
• Excellent communication and interpersonal skills to effectively interact with, and articulate complex information to a variety of stakeholders, both internally and externally.
• Demonstrated analytical skills to recognize inconsistencies, research and come to a conclusion, and the ability to identify and approach complex problems from different angles.
• Self-starter with strong attention to detail, critical thinking skills, and ability to multi-task.
• Naturally curious, inquisitive, and willing to ask questions to achieve goals focused on the desired outcomes.
• Demonstrated ability to navigate and thrive in ambiguous situations, effectively adapting to changing priorities and making informed decisions with limited information. Ability and willingness to approach complex problems from different angles and to produce creative, innovative solutions all while ensuring compliance with laws.
• Proficiency with Microsoft Office Suite, including Excel, Word, PowerPoint.
• Less than 5% travel, as needed.

Preferred:

• Strong understanding of Section 1557 of the Affordable Care Act and other federal nondiscrimination laws is preferred.
• Juris Doctor (JD).
• Regulatory, Compliance, Risk, Audit experience in healthcare industry.
• Demonstrated experience implementing and maintaining cross-functional processes to comply with federal laws.
• Strong understanding of Mental Health Parity laws is preferred.

Additional Information

a. Serve as Wellmark’s subject matter expert for nondiscrimination and mental health parity protocols, and coordinate compliance in all matters pertaining to nondiscrimination and mental health parity laws.

b. Ensure Wellmark’s written corporate policies and procedures comply with mental health parity requirements, and Section 1557 and other federal nondiscrimination requirements, including language access services, reasonable modifications for individuals with disabilities, and stakeholder and communication strategies.

c. Cascade and communicate various nondiscrimination and mental health parity requirements and initiatives to team members and support overall compliance with requirements.

d. Develop and maintain Wellmark Notice of Nondiscrimination and Notice of Availability of Language Assistance for use by internal stakeholders and support stakeholders in incorporating notice into required written and electronic communications, website, and other communications required by federal law.

e. Receive, review and investigate complaints or grievances alleging discrimination under Section 1557, other nondiscrimination laws, or mental health parity laws. Conduct thorough investigation, document findings, and file all necessary reports.

f. Ensure compliance with recordkeeping requirements; maintains detailed records of all grievances, investigations, and corrective actions taken, including necessary reporting to government entities.

g. Create and deliver comprehensive training and education programs to Wellmark employees on mental health parity requirements, and 1557 regulations and other federal nondiscrimination requirements, including how to respond to discrimination concerns and how to report potential violations.

h. Facilitate cross-functional meetings to establish processes to assess and mitigate compliance risk relating to nondiscrimination and mental health parity.

i. Continually evolve nondiscrimination and mental health parity processes and oversight at Wellmark through collaboration with various departments across the organization to promote awareness of nondiscrimination and mental health parity requirements, influence department procedures, and provide corporate-wide compliance oversight across the company.

j. Conduct regular reviews to identify potential areas of non-compliance and assist stakeholders in developing corrective action plans. Lead organization efforts for internal and external audits of nondiscrimination and mental health parity requirements, as well as any required remediation and/or corrective action plans.

k. Consult with legal counsel, as needed to address complex complaints and grievances, obtain interpretations, and to ensure compliance.

l. Establish and provide oversight of third-party oversight protocols compliance with federal nondiscrimination laws and mental health parity requirements.

m. Participate in workgroup and provide guidance and compliance oversight in regard to federal and state nondiscrimination and mental health parity requirements.

n. Other duties as assigned.

An Equal Opportunity Employer

The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.

Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at [emailprotected]