1557 Compliance Program Manager

Wellmark is looking for a passionate individual to manage our nondiscrimination program. This individual will act as Wellmarks designated Civil Rights Coordinator responsible for serving as a subject matter expert and coordinating compliance with provisions of the Affordable Care Acts (ACA) Section 1557 Section 504 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 Wellmarks 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 build 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 detailoriented 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 relationshipbuilding 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:

• Bachelors 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.
• Selfstarter with strong attention to detail critical thinking skills and ability to multitask.
• 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 crossfunctional processes to comply with federal laws.
• Strong understanding of Mental Health Parity laws is preferred.

Additional Information :

a. Serve as Wellmarks 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 Wellmarks 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 supporting 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 files 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 crossfunctional 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 corporatewide compliance oversight across the company.

j. Conduct regular reviews to identify potential areas of noncompliance 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

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