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Healthcare Nondiscrimination Program Manager

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, 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 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 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 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 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 [email protected]

Please inform us if you meet the definition of a "Covered DoD official".

Average salary estimate

$80000 / YEARLY (est.)
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$90000K

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What You Should Know About Healthcare Nondiscrimination Program Manager, Wellmark, Inc.

At Wellmark, we're on a mission to ensure that every member feels respected and valued, and to lead this important charge, we're looking for a Healthcare Nondiscrimination Program Manager in Sioux Falls, SD. In this role, you'll be the go-to expert on all things related to civil rights and nondiscrimination within our health program operations. You'll take the reins as our designated Civil Rights Coordinator, working closely with other departments to ensure compliance with the Affordable Care Act’s Section 1557, Section 504, and various state and federal laws aimed at preventing discrimination. You'll handle grievances with care, manage compliance training for our staff, and regularly communicate essential nondiscrimination protocols to the wider organization. If you have a keen eye for detail and a passion for regulatory compliance, you’ll thrive here! We’re also looking for someone with strong analytical skills and an innovative spirit to help us navigate the complexities of regulatory requirements. By fostering solid relationships across the company, you’ll be an integral player in helping Wellmark adapt and thrive as regulations evolve. With a supportive work environment and commitment to member well-being, this is more than just a job; it's a chance to make a real difference in our community!

Frequently Asked Questions (FAQs) for Healthcare Nondiscrimination Program Manager Role at Wellmark, Inc.
What are the main responsibilities of a Healthcare Nondiscrimination Program Manager at Wellmark?

As a Healthcare Nondiscrimination Program Manager at Wellmark, your primary responsibilities include serving as the Civil Rights Coordinator, ensuring compliance with various nondiscrimination laws, managing grievances, and facilitating training programs for staff. You’ll also oversee audits and collaboration with internal and external stakeholders to maintain and improve our nondiscrimination policies.

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What qualifications are required for the Healthcare Nondiscrimination Program Manager position at Wellmark?

To qualify for the Healthcare Nondiscrimination Program Manager at Wellmark, candidates need a bachelor’s degree or equivalent work experience, along with at least four years of experience in a regulatory or compliance role. Strong communication skills, an understanding of nondiscrimination laws like ACA Section 1557, and the ability to build relationships are also essential.

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How does Wellmark approach training and compliance regarding nondiscrimination laws?

Wellmark prioritizes compliance and is committed to developing comprehensive training programs for employees, educatin them on mental health parity requirements and nondiscrimination regulations. As the Healthcare Nondiscrimination Program Manager, you will lead these training initiatives to ensure that all staff understand their role in maintaining compliance.

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What is the work environment like for the Healthcare Nondiscrimination Program Manager at Wellmark?

Working as the Healthcare Nondiscrimination Program Manager at Wellmark means being part of a supportive and dynamic environment focused on member well-being and compliance. You'll collaborate with diverse teams, participate in audits, and engage in problem-solving discussions that encourage innovation while ensuring adherence to nondiscrimination laws.

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Can you describe the growth opportunities for a Healthcare Nondiscrimination Program Manager at Wellmark?

At Wellmark, there are abundant opportunities for growth and professional development. The Healthcare Nondiscrimination Program Manager role is pivotal in advancing your expertise and career within compliance and regulatory fields, offering chances to participate in industry workgroups and gain significant visibility throughout the organization.

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Common Interview Questions for Healthcare Nondiscrimination Program Manager
What experience do you have related to compliance with federal nondiscrimination laws?

When discussing your experience with compliance, focus on specific projects that required an understanding of nondiscrimination laws. Discuss your role in developing policies, managing grievances, or delivering training programs, highlighting measurable outcomes or improvements.

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How would you handle a grievance alleging discrimination under Section 1557?

In responding to a grievance under Section 1557, stress the importance of a fair and thorough investigation. Detail your approach to documentation, communication with the involved parties, and how you would ensure compliance with regulations while seeking a resolution.

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Can you describe a time you successfully implemented a compliance policy?

Think of a specific instance where you developed or implemented a compliance policy. Describe the objectives, the steps you took to engage stakeholders, and the outcomes of your efforts—focus on how it improved compliance or operational efficiency.

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What strategies do you employ to build strong relationships across departments?

Building relationships requires transparency and consistent communication. Explain how you make efforts to connect with team members, share knowledge, and foster collaboration on compliance initiatives, emphasizing successful outcomes from these relationships.

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How do you stay updated on changes in federal and state nondiscrimination laws?

Staying informed is critical in compliance roles. Discuss your strategies for keeping up to date, such as attending workshops, subscribing to legal updates, or being active in industry organizations that help you remain knowledgeable about regulatory changes.

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What challenges have you faced in compliance management, and how did you overcome them?

Share specific challenges you encountered, such as changes in regulations or compliance failures. Describe your analytical approach to these challenges, the solutions you implemented, and the lessons learned that led to improved processes.

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How would you communicate complex regulations to non-experts in the organization?

Emphasize the need for clear, relatable language and effective communication tools. Discuss your approach to translating complex regulations into actionable steps, possibly sharing examples of materials you’ve created or workshops you’ve conducted.

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What role do you think training plays in ensuring compliance?

Training is vital in fostering a culture of compliance. Detail how you design and implement training programs to ensure employees understand their responsibilities, how it impacts the organization, and examples of successful sessions you’ve led.

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Can you describe your experience with audits related to nondiscrimination compliance?

Share your direct experience with audits, your role in coordinating or implementing findings, and how you've used audit results to enhance compliance measures. Highlight any specific outcomes or changes that resulted from audit processes.

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What is your understanding of mental health parity requirements?

Discuss your knowledge regarding mental health parity laws, how they intersect with nondiscrimination requirements, and share any practical steps you’ve taken to ensure compliance related to these laws in your previous roles.

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Wellmark, headquartered in Des Moines, Iowa, and established in 1939, is a health insurance company specializing in individual and family health insurance plans.

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Full-time, on-site
DATE POSTED
March 7, 2025

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