Mental Health Parity Clinical Reviewer (Remote)

Summary

This position is responsible for providing support to United States based Health and Benefits Consultants and Clients. Within this role, as a member of North America client team, you will collect and analyze written information that informs strategic business decisions. The expectation will be to produce client facing analytical reports efficiently and accurately.

Your role on individual projects will include elements such as written documentation collection from vendors/ carriers, information validation, data extracts, conducting focused analyses, developing executive summary for senior H&B stakeholders & client presentations, and other activities.

You will continually learn about North America health and benefits concepts and principles and apply these skills in a global environment. Finally, you will interact with other members of our United States Health and Benefits team and can make important contributions to process improvements and new analytical tools.

This position requires an analytical mind who is detail oriented with work product and outputs using Microsoft Office tools. The position also requires the ability to accurately execute written and verbal instructions.

The Role

Manage NQTL written comparative analysis portion of parity assessment, including:

• Complete reviews of medical and pharmacy documentation illustrating compliance with MHPAEA


• Coordinate with Project Manager regarding sending requests, timing, status, and follow-up


• Attend internal and client kick off meeting with QTL/NQTL team


• Monitor carrier and vendor responsiveness to information requests


• Validate completeness of response and report any issues or impact to timeline proactively to Project Manager


• Complete initial review of carrier responses for parity projects


• Draft comparative analysis based on documents reviewed including master templates and client specific responses


• Collaborate with MHPAEA senior reviewer and Project Manager to conduct follow up calls/emails with carriers/vendors as needed for clarification and submission of additional documentation


• Support the overall completion of the NQTL written documentation analysis component of the report


• Participate in delivering comparative analysis results to clients


• Participate in MHPAEA office hours as needed


• Maintain materials/documentation in a manner consistent with WTW work processes and peer review standards (e.g., filing of drafts, deliverables, client and carrier documentation)

Required Skills and knowledge:

• 5-7 years’ experience dealing with health and welfare plans, ideally gained in a benefit consulting/brokerage firm, Health Plan, Third Party Administrator, Regulatory Agency, Legal/Compliance Firm, or insurance company
• Active, unrestricted RN license preferred, but commensurate clinical compliance experience may also be considered
• Understanding of health plan utilization/case management processes, network management, credentialing, quality management, pharmacy prior-authorization processes and health plan operations
• Basic understanding of Mental Health Parity and Mental Health Parity Non-Qualitative Treatment Limits
• Well-organized and detail oriented
• Strong project management and critical thinking skills
• Self- starter attitude and ability to work individually and as part of a team
• Strong written and verbal communication skills
• Sense of accountability and ownership
• Flexibility and proven ability to identify and resolve issues
• Strong analytical, creative, and integrative skills
• Ability to ask the right questions and seek help where appropriate, from colleagues and clients.
• Strong client service orientation and ability to respond to all communications effectively and in a timely manner
• Excellent Microsoft Office skills, particularly in Word, Excel and Power Point

Note: Employment-based non-immigrant visa sponsorship and/or assistance is not offered for this specific job opportunity.

Compensation and Benefits

Base salary range and benefits information for this position are being included in accordance with requirements of various state/local pay transparency legislation. Please note that salaries may vary for different individuals in the same role based on several factors, including but not limited to location of the role, individual competencies, education/professional certifications, qualifications/experience, performance in the role and potential for revenue generation (Producer roles only).

Compensation

The base salary compensation range being offered for this role is $185,000 - $225,000 USD per year.

This role is also eligible for an annual short-term incentive bonus.

Company Benefits

WTW provides a competitive benefit package which includes the following (eligibility requirements apply):

• Health and Welfare Benefits:

  Medical (including prescription coverage), Dental, Vision, Health Savings Account, Commuter Account, Health Care and Dependent Care Flexible Spending Accounts, Group Accident, Group Critical Illness, Life Insurance, AD&D, Group Legal, Identify Theft Protection, Wellbeing Program and Work/Life Resources (including Employee Assistance Program)

• Leave Benefits:

  Paid Holidays, Annual Paid Time Off (includes paid state/local paid leave where required), Short-Term Disability, Long-Term Disability, Other Leaves (e.g., Bereavement, FMLA, ADA, Jury Duty, Military Leave, and Parental and Adoption Leave), Paid Time Off (Washington State only)

• Retirement Benefits:

  Contributory Pension Plan and Savings Plan (401k). All Level 38 and more senior roles may also be eligible for non-qualified Deferred Compensation and Deferred Savings Plans

This position will remain posted for a minimum of three business days from the date posted or until sufficient/appropriate candidate slate has been identified.

EOE, Including Disability/Vets