Remote Clinical Program Consultant, Mental Health Parity RN

UnitedHealthcare

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Requisition Number: 2178889
Job Category: Medical & Clinical Operations
Primary Location: Wausau, WI
(Remote considered)

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. 

This position will be responsible for supporting care management product and operations reporting to the Vice President of Care Management Quality for UMR. Clinical performance is charged with effectively implementing, monitoring, and executing on programs related to driving affordability, clinical quality activities across the UMR Third Party Administration business.

Scope: UMR

If you are located in Central or Mountain Time Zone, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

  • Ensure we are meeting Mental Health Parity requirements, acting as MHP Subject Matter Expert (SME)
  • Collect, monitor, and document changes to requirements to mitigate risks and achieve regulatory adherence
  • Manage escalated Mental Health Parity inquiries from customers, state/federal regulators or internal business partners
  • Ensure written standards and procedures to support training, communication and education
  • Support the collection of data and coordinate/create responses to MHP inquiries, audits, and exams
  • Acts as a liaison between teams coordinate implementation activities
  • Ensure proper reporting and response to state/federal and internal stakeholders
  • Conduct monitoring activities to ensure compliance with MHP program infrastructure
  • Provide support for and participate in regulatory audits
  • Conduct MHP state-specific regulatory research with ability to understand and operationalize state and federal laws, as well as obtain Legal, Compliance, & Regulatory Affairs (LCRA) input as needed
  • Lead and/or facilitate the development of business strategy and operational processes to meet MHP requirements
  • Evaluate utility of reporting methods and visual representations frequently in order to most effectively communicate through data
  • Maintains integrity and quality of data and assures data conformity meets operational requirements and goals
  • Other duties as assigned

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • Active and unrestricted Registered Nurse license in primary state of residence
  • 3+ years of working experience with health plans or managed care environment gaining an understanding of utilization/case management processes
  • Professional experience gaining working knowledge of US mental Health Parity and Mental Health Parity Non-Quantitative Treatment Limits
  • Experience working in a complex matrixed work environment with competing priorities and deliverables
  • Experience with verbal and written technical correspondence with all levels of the organization and external stakeholders
  • Demonstrated ability to effectively communicate with internal and external stakeholders
  • Proven critical thinking to problem solve complex issues; including multiple priorities and research conflicting and / or inaccurate data
  • Intermediate level of proficiency with MS Excel, MS Word, MS PowerPoint and Microsoft Teams
  • Ability to travel up to 20% travel, as needed

Preferred Qualifications:

  • Bachelor’s degree or higher
  • Experience with HEDIS measurements, analytics and reporting
  • Mental Health Parity (MHPAEA) state and federal regulatory experience
  • Quality management, project management or care management experience
  • Demonstrated ability to practice effective time management skills and organization
  • Demonstrated ability to evaluate and implement process improvement strategies
  • Proven ability to work with autonomy and minimal guidance; seeks guidance on only the most complex tasks

Colorado Residents Only: The salary range for Colorado residents is $85,000 to $167,300. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy